Department of Maxillofacial Surgery, Medical University, Plovdiv, Bulgaria.
Int J Oral Maxillofac Surg. 2009 Nov;38(11):1188-93. doi: 10.1016/j.ijom.2009.06.026. Epub 2009 Jul 28.
The aim of this study was to examine if cessation of smoking after surgical excision of oral potentially malignant lesions in smokers reduced the risk of recurrences, development of new lesions or malignancies. 51 patients with oral leukoplakia or erythroplakia were included. They were daily smokers at the time of diagnosis and were treated surgically. Patients were advised to quit smoking at each visit. The change of smoking habits and occurrence of unfavorable events were noted during follow-up. Descriptive statistics, Fischer's exact test, Kaplan-Meier curves with log-rank test, and Cox proportional hazards model were used for analysis. 16 patients (31%) quit smoking during the observation period. Only one quitter (6%) developed recurrence compared with 11 continuing smokers (33%) (p<0.05). There were no new lesions and no malignancies among quitters compared with 8 new lesions (p<0.05) and 5 carcinomas (p>0.05) in continuing smokers. Multivariate analysis showed continuing smoking to be the most significant factor for occurrence of unfavorable events, OR 23.7. In conclusion, cessation of smoking significantly reduced the risk of unfavorable events after surgical treatment of oral potentially malignant lesions in smokers.
本研究旨在探讨口腔潜在恶性病变（Oral potentially malignant lesions，OPML）患者接受手术切除后戒烟是否能降低复发、新发病变或恶性肿瘤的风险。纳入了 51 例口腔白斑病或红斑病患者。他们在诊断时为每日吸烟者，接受手术治疗。患者每次就诊时均被建议戒烟。在随访期间记录了吸烟习惯的变化和不良事件的发生情况。采用描述性统计、Fischer 确切检验、Kaplan-Meier 曲线和对数秩检验、Cox 比例风险模型进行分析。16 名患者（31%）在观察期间戒烟。与 11 名继续吸烟者（33%）相比，只有一名戒烟者（6%）出现复发（p<0.05）。与继续吸烟者中 8 例新发病变（p<0.05）和 5 例癌（p>0.05）相比，戒烟者中没有新发病变和恶性肿瘤。多变量分析显示，继续吸烟是不良事件发生的最显著因素，OR 23.7。综上所述，戒烟显著降低了吸烟患者口腔潜在恶性病变手术后不良事件的风险。
