Balasundram Sathesh, Mustafa Wan Mahadzir Wan, Ip Jolene, Adnan Tassha Hilda, Supramaniam Premaa
Department of Oral Surgery, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2012;13(8):4045-50. doi: 10.7314/apjcp.2012.13.8.4045.
The impact of ablative oral cancer surgery was studied, with particular reference to recurrence and nodal metastasis, to assess survival probability and prognostic indicators and to elucidate if ethnicity influences the survival of patients.
Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and clinical records were assessed. Inclusion criteria were stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009. All individuals had a pre-operative assessment prior to the surgery. The post operative assessment period ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves.
87 patients (males:38%; females:62%) were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal recurrence was detected in 5.7% while 20.5% had primary site recurrence within the study period. Kaplan-Meier survival analysis revealed that the median survival time was 57 months. One year overall survival (OS) rate was 72.7% and three year overall survival rate dropped to 61.5%. On OS analysis, the log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033). Recurrence-free survival (RFS) analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. One year RFS rate was 85.2% and the three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001).
Conservative neck is effective, in conjunction with postoperative radiotherapy, for control of neck metastases. Ethnicity appears to influence the survival of the patients, but a prospective trial is required to validate this.
研究口腔癌根治性手术的影响，尤其关注复发和淋巴结转移情况，评估生存概率和预后指标，并阐明种族是否会影响患者的生存情况。
确定接受头颈部根治性手术并进行颈部清扫的患者，并评估其临床记录。纳入标准为2004年至2009年期间需要进行手术切除且可能接受或不接受放疗的I-IV期口腔和口咽恶性肿瘤患者。所有患者在手术前均进行了术前评估。术后评估期为1年至5年。使用Kaplan-Meier曲线分析生存分布情况。
本研究纳入了87例患者（男性：38%；女性：62%），年龄范围为21-85岁。约78%的患者接受了颈部清扫，63%的患者接受了手术和放疗。在研究期间，5.7%的患者检测到淋巴结复发，20.5%的患者出现原发部位复发。Kaplan-Meier生存分析显示，中位生存时间为57个月。一年总生存率（OS）为72.7%，三年总生存率降至61.5%。在OS分析中，对数秩检验显示马来族和华裔患者的生存存在显著差异（Bonferroni校正p=0.033）。无复发生存（RFS）分析显示，25%的患者在46个月时达到复发事件。一年RFS率为85.2%，三年生存率为76.1%。在RFS分析中，对数秩检验显示复发和淋巴结转移事件存在显著差异（p<0.001）。
保守性颈部治疗结合术后放疗对控制颈部转移有效。种族似乎会影响患者的生存情况，但需要进行前瞻性试验来验证这一点。
