Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University at Linko, Taoyuan, Taiwan, ROC.
Ann Surg Oncol. 2010 Apr;17(4):1118-26. doi: 10.1245/s10434-009-0894-6. Epub 2010 Feb 5.
The American Joint Committee on Cancer staging system suggests that squamous-cell carcinoma of the oral cavity (OSCC) with pN2 should be classified as stage IVA. The objective of the current study was to determine the outcome of patients with pN2 OSCC cancer according to different T status.
Between January 1996 and September 2007, a total of 270 patients with pN2 OSCC cancer were analyzed. All participants had a follow-up of at least 2 years or were censored on the date of last follow-up. The outcome measures for this study were the 5-year rates of locoregional control, distant metastases, and survival.
Five-year disease-specific survival and overall survival rates in pT1 (n = 9), pT2 (n = 98), pT3 (n = 70), and pT4 (n = 93) patients were 78%, 66%, 49%, 35% (P = 0.0031), and 78%, 52%, 35%, 23% (P = 0.0001), respectively. Multivariable analysis revealed that pT3-4, level IV/V metastases, extracapsular spread, and poor differentiation were independent risk factors for 5-year disease-specific survival in the entire study cohort. Specific independent prognostic factors for 5-year disease-specific survival according to T stage were found.
The results of this study suggest that patients with pN2 OSCC cancer have different outcomes and prognostic factors according to their T status. In the light of these findings, treatment strategies may be quite different.
美国癌症联合委员会（AJCC）分期系统建议口腔鳞状细胞癌（OSCC）伴 pN2 应归类为 IVA 期。本研究旨在根据不同的 T 分期来确定 pN2 OSCC 患者的预后。
1996 年 1 月至 2007 年 9 月期间，共分析了 270 例 pN2 OSCC 患者。所有患者的随访时间均至少为 2 年，或截止至末次随访日期。本研究的结局指标为局部区域控制、远处转移和生存的 5 年率。
pT1（n = 9）、pT2（n = 98）、pT3（n = 70）和 pT4（n = 93）患者的 5 年疾病特异性生存率和总生存率分别为 78%、66%、49%和 35%（P = 0.0031）以及 78%、52%、35%和 23%（P = 0.0001）。多变量分析显示，pT3-4、IV/V 水平转移、包膜外扩散和低分化是整个研究队列中 5 年疾病特异性生存率的独立危险因素。根据 T 分期，还发现了 5 年疾病特异性生存率的特定独立预后因素。
本研究结果表明，pN2 OSCC 患者的结局和预后因素因 T 分期而异。根据这些发现，治疗策略可能会有很大的不同。
