Division of Head and Neck Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Am J Otolaryngol. 2012 Nov-Dec;33(6):673-7. doi: 10.1016/j.amjoto.2012.04.006. Epub 2012 Jun 6.
The aim of this study was to analyze the outcome of surgical therapy for buccal squamous cell carcinoma (SCCA) at a single tertiary care institution during a 40-year period.
A retrospective review was performed by examining the records and pathology of 48 patients with buccal SCCA treated at a single tertiary care institution from 1970 to 2009.
Treatment entailed surgery alone in 18 patients (37.5%) and surgery followed by radiation therapy in 30 patients (62.5%). Composite resection was performed in 17 patients (35.4%), and ipsilateral neck dissections were performed in 37 patients (77.1%). One-year observed actuarial disease-free survival rates were 60%, 46%, 0%, and 40% for T1 through T4, respectively. Univariate analysis revealed increased age as a risk factor for disease recurrence (P = .062), with skin taken and neck dissection not achieving significance (P = .24 and .20, respectively). Multivariate analysis demonstrated age as increasing risk and neck dissection as decreasing risk of recurrence (P = .029 and .023, respectively).
We report relatively high disease-free survival rates in patients who underwent aggressive resection and neck dissection. Performance of neck dissection and younger age were associated with a favorable prognosis. Performance of neck dissection may decrease the risk of recurrence in primary SCCA of the buccal mucosa. Although through-and-through resection of skin decreased risk of disease recurrence, this difference is not statistically significant (P = .24).
本研究旨在分析 40 年间单一体位治疗机构中颊部鳞状细胞癌（SCCA）的手术治疗结果。
通过检查 1970 年至 2009 年单一体位治疗机构中 48 例颊部 SCCA 患者的记录和病理资料，进行回顾性研究。
18 例（37.5%）患者接受单纯手术治疗，30 例（62.5%）患者接受手术联合放疗。17 例（35.4%）患者行复合切除术，37 例（77.1%）患者行同侧颈清扫术。T1 至 T4 患者的 1 年观察无复发生存率分别为 60%、46%、0%和 40%。单因素分析显示，年龄增加是疾病复发的危险因素（P=0.062），取皮和颈清扫术无统计学意义（P=0.24 和 P=0.20）。多因素分析表明，年龄是复发风险增加的因素，颈清扫术是复发风险降低的因素（P=0.029 和 P=0.023）。
我们报告了接受积极切除和颈清扫术的患者相对较高的无复发生存率。行颈清扫术和年龄较小与良好的预后相关。颈清扫术可能降低颊部口腔原发性 SCCA 的复发风险。虽然皮肤的贯穿性切除降低了疾病复发的风险，但这一差异无统计学意义（P=0.24）。
