Wang Yan-Hong, Chen Yan-Feng, Guo Zhu-Ming, Zhang Quan, Liu Tian-Ren, Chen Fu-Jin
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China.
Ai Zheng. 2009 May;28(5):524-7.
The therapeutic outcome of early stage squamous cell carcinoma of the oral tongue (SCCOT) is generally satisfactory. Recurrence is a major factor affecting the treatment efficacy of SCCOT. This study was to investigate the reasons for recurrence and prognostic factors of SCCOT, thus to decrease the recurrence rate and improve the therapeutic effect.
In total 227 patients with SCCOT treated in Sun Yat-sen University Cancer Center from January 1992 to December 2003 were retrospectively reviewed. The Kaplan-Meier method was used to analyze the survival rate, the log-rank test was used to compare survival distributions, and the Chi-square test was adopted to compare different factors affecting recurrence. Multivariate analysis was performed using the Cox proportional hazard model.
The recurrence rate was significantly lower in patients with well differentiated SCCOT (19.3%) than in those with moderately-poorly differentiated SCCOT (39.2%) (P=0.004), and was significantly lower in patients receiving combined therapy (15%) than in those receiving surgery alone (28%) (P=0.014). The overall 3-year and 5-year survival rates in recurrent and non-recurrent groups were 40.7% vs. 87.3% and 25.9% vs. 80.3%, respectively(P=0.000). The overall 3-year and 5-year survival rates were also significantly different in patients > or =45 years and < 45 years (P=0.021), and in those with or without neck dissection (P=0.023).
The pathological classification and whether receiving combination therapy are the factors affecting recurrence of SCCOT. Age, neck dissection and recurrence are prognostic factors of SCCOT. Age and recurrence are independent factors of SCCOT.
早期舌鳞状细胞癌（SCCOT）的治疗效果总体令人满意。复发是影响SCCOT治疗效果的主要因素。本研究旨在探讨SCCOT复发的原因及预后因素，从而降低复发率，提高治疗效果。
回顾性分析1992年1月至2003年12月在中山大学肿瘤防治中心接受治疗的227例SCCOT患者。采用Kaplan-Meier法分析生存率，用log-rank检验比较生存分布，采用卡方检验比较影响复发的不同因素。使用Cox比例风险模型进行多因素分析。
高分化SCCOT患者的复发率（19.3%）显著低于中低分化SCCOT患者（39.2%）（P=0.004），接受联合治疗患者的复发率（15%）显著低于单纯接受手术治疗的患者（28%）（P=0.014）。复发组和未复发组的3年和5年总生存率分别为40.7%对87.3%和25.9%对80.3%（P=0.000）。年龄≥45岁和＜45岁的患者以及有或无颈淋巴结清扫的患者，其3年和5年总生存率也有显著差异（P=0.021和P=0.023）。
病理分类及是否接受联合治疗是影响SCCOT复发的因素。年龄、颈淋巴结清扫和复发是SCCOT的预后因素。年龄和复发是SCCOT的独立预后因素。
