Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Ann Surg Oncol. 2012 Jun;19(6):2003-10. doi: 10.1245/s10434-011-2214-1. Epub 2012 Jan 20.
The determining risk factors for patients with squamous cell carcinoma of the hard palate are not well verified.
Medical records from our facility of all patients with squamous cell carcinoma of the hard palate receiving curative surgery between March 2003 and May 2009 were reviewed.
Seventy-eight patients were enrolled in the study. The 5 year disease-free and overall survival rates were 49.8 and 49.7%, respectively. The 5 year disease-free and overall survival rates were statistically different between positive/close margins and negative margins (24.6% vs. 65.4%, P = 0.02; 20.1% vs. 63.1%, P = 0.001, respectively), with and without soft palate invasion (38.8% vs. 68.9%, P = 0.02; 27.4% vs. 77.5%, P = 0.001, respectively), and soft palate invasion patients with and without perineural invasion (10.4% vs. 52.8%, P = 0.02; 0% vs. 38.1%, P = 0.008, respectively). The rate of positive nodal metastasis for T3 and T4 tumors was 44%. For the tumor with soft palate invasion, the rate of positive nodal metastasis was 29%. After multivariate analyses, soft palate invasion and positive/close margins were the determining risk factors for disease-free and overall survival.
Soft palate invasion and positive/close margins were the determining risk factors for disease-free and overall survival in patients with squamous cell carcinoma of the hard palate. Elective neck dissection is suggested for advanced primary tumors (T3 or T4) or tumors with soft palate invasion.
硬腭鳞状细胞癌患者的确定风险因素尚未得到很好的验证。
回顾了 2003 年 3 月至 2009 年 5 月期间在我院接受根治性手术的所有硬腭鳞状细胞癌患者的病历。
共有 78 例患者入组研究。5 年无病生存率和总生存率分别为 49.8%和 49.7%。阳性/切缘阳性和阴性边缘的 5 年无病生存率和总生存率有统计学差异（24.6%比 65.4%，P = 0.02；20.1%比 63.1%，P = 0.001），有和无软腭侵犯（38.8%比 68.9%，P = 0.02；27.4%比 77.5%，P = 0.001），以及有和无神经周围侵犯的软腭侵犯患者（10.4%比 52.8%，P = 0.02；0%比 38.1%，P = 0.008）。T3 和 T4 肿瘤的阳性淋巴结转移率为 44%。对于有软腭侵犯的肿瘤，阳性淋巴结转移率为 29%。多因素分析后，软腭侵犯和阳性/切缘阳性是无病和总生存率的决定因素。
软腭侵犯和阳性/切缘阳性是硬腭鳞状细胞癌患者无病和总生存率的决定因素。对于晚期原发性肿瘤（T3 或 T4）或有软腭侵犯的肿瘤，建议选择性颈部清扫术。
