Girod Angélique, Mosseri Véronique, Jouffroy Thomas, Point Daniel, Rodriguez José
Oral and Maxillofacial Surgeon, Head and Neck Oncology Unit, Institut Curie, Paris, France.
J Oral Maxillofac Surg. 2009 Sep;67(9):1914-20. doi: 10.1016/j.joms.2009.04.031.
Incidence of squamous cell carcinoma (SCC) of the oral cavity and oropharynx is increasing in French female patients. The objective of this study was to study the clinical and demographic characteristics and the prognosis of this female population. Secondary outcomes were to determine if a subgroup of patient had a different prognosis.
A prospective study from 1989 to 2002 of all female patients presenting SCC of the upper aerodogestive tract was conducted. Data for 171 women were extracted. Clinical and histological features were analyzed using chi(2) and log-rank tests along with the Kaplan Meier method and multivariate analysis using the Cox regression procedure.
Mean patient age was 62 years. Of the study population, 48.5% used tobacco and 34.5% used alcohol. The relative risk of death for overall and cancer-specific survival increased for patients below the age of 45 or over the age of 70 (95% Cl; 0.3-1.05; P = .0085). Tobacco consumption decreased cancer-specific and overall survival (P = .0008 and .0001, respectively). The other prognostic factors we found were tumor and nodal status, previous or simultaneous cancer, oral cavity primary site.
Prognosis of oropharyngeal and oral squamous cell carcinomas is less favorable in females who smoke as well as in younger and older women. With these patients, the oversight must be closer. Smoking, however, should be stopped.
法国女性口腔和口咽鳞状细胞癌(SCC)的发病率正在上升。本研究的目的是研究该女性人群的临床和人口统计学特征以及预后。次要结果是确定是否有亚组患者具有不同的预后。
对1989年至2002年所有患有上呼吸消化道SCC的女性患者进行了一项前瞻性研究。提取了171名女性的数据。使用卡方检验和对数秩检验以及Kaplan Meier方法分析临床和组织学特征,并使用Cox回归程序进行多变量分析。
患者平均年龄为62岁。在研究人群中,48.5%的人吸烟,34.5%的人饮酒。45岁以下或70岁以上患者的总体生存和癌症特异性生存的死亡相对风险增加(95%置信区间;0.3 - 1.05;P = .0085)。吸烟降低了癌症特异性生存和总体生存(分别为P = .0008和.0001)。我们发现的其他预后因素是肿瘤和淋巴结状态、既往或同时发生的癌症、口腔原发部位。
口咽和口腔鳞状细胞癌在吸烟女性以及年轻和老年女性中的预后较差。对于这些患者,必须进行更密切的监测。然而,应该戒烟。