Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan.
Tohoku J Exp Med. 2011 Jan;223(1):17-25. doi: 10.1620/tjem.223.17.
Oral squamous cell carcinoma is one of the most frequent types of head and neck cancers in Japan. Although recent reports have shown positive results of non-surgical treatment for advanced head and neck squamous cell carcinoma, including tongue cancer, no clear treatment strategies have been established for oral cancers, except for tongue cancer. To assess appropriate therapies, we conducted a retrospective chart review of 114 Japanese patients with oral cancers that were pathologically diagnosed as squamous cell carcinoma, excluding tongue cancers. The overall and the disease specific 5-year survival rates were 53% and 61%, respectively. Univariate and multivariate analyses revealed a lower stage (I, II, or III) and non-surgical treatment as good and poor prognostic factors of oral squamous cell carcinoma, respectively, based on their hazard ratios of 0.17 (95% CI 0.045-0.60, p = 0.0061) and 5.3 (95% CI 2.7-11, p < 0.0001). Furthermore, impact of surgery was well documented in the operable stage IVa cancers (p = 0.00015). The surgical treatment consisted of the wide resection of the primary tumor and the neck dissection for stage III or IV tumors. The present data also suggest that adjunctive therapy, such as post-operative radiation therapy or post-operative chemo-radiation therapy, shows no survival benefit compared to the surgery alone. We therefore recommend the surgical treatment for advanced oral squamous cell carcinoma in Japanese patients. These results would be helpful in future clinical trials, especially in non-surgical treatment studies of oral squamous cell carcinoma in Japan.
口腔鳞状细胞癌是日本最常见的头颈部癌症之一。尽管最近的报告显示，包括舌癌在内的晚期头颈部鳞状细胞癌的非手术治疗取得了积极的结果，但除了舌癌之外，口腔癌还没有明确的治疗策略。为了评估适当的治疗方法，我们对 114 例经病理诊断为鳞状细胞癌（不包括舌癌）的日本口腔癌患者进行了回顾性图表审查。总的和疾病特异性 5 年生存率分别为 53%和 61%。单因素和多因素分析显示，较低的分期（I、II 或 III）和非手术治疗分别是非口腔鳞状细胞癌的良好和不良预后因素，其风险比分别为 0.17（95%CI 0.045-0.60，p=0.0061）和 5.3（95%CI 2.7-11，p<0.0001）。此外，手术在可手术的 IVa 期癌症中的作用得到了很好的证明（p=0.00015）。手术治疗包括原发肿瘤的广泛切除和 III 或 IV 期肿瘤的颈部清扫。目前的数据还表明，辅助治疗，如术后放疗或术后放化疗，与单纯手术相比没有生存获益。因此，我们建议对日本晚期口腔鳞状细胞癌患者进行手术治疗。这些结果将有助于未来的临床试验，特别是在日本口腔鳞状细胞癌的非手术治疗研究中。
