Fried David, Mullins Brandon, Weissler Mark, Shores Carol, Zanation Adam, Hackman Trevor, Shockley William, Hayes Neil, Chera Bhishamjit S
Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Head Neck. 2014 Jun;36(6):776-81. doi: 10.1002/hed.23367. Epub 2013 Jul 30.
It is unclear whether bone invasion in small oral cavity squamous cell carcinomas (OCSCC) results in worse prognosis.
Two hundred fifty-four patients with OCSCC were identified and divided into 3 cohorts: (1) ≤4 cm with no bone invasion; (2) ≤4 cm with bone invasion; and (3) ≥4 cm or other factors (eg, skin invasion, deep muscle invasion) that would qualify for American Joint Committee on Cancer (AJCC) T4 classification aside from bone invasion. Depth of bone invasion (none, cortical, or medullary) was also recorded.
Cohorts 1 and 2 had similar outcomes. Cohort 3 had lower rates of regional control (p = .04), disease-specific survival (DSS; p < .01), and overall survival (OS; p < .01). On multivariate analysis, margin status and medullary bone invasion were associated with worse outcomes.
Bone invasion does not seem to significantly influence outcomes in patients with small primary tumors treated with surgery/radiation. Medullary bone invasion seems to result in reduced rates of control and survival.
小口腔鳞状细胞癌（OCSCC）中的骨侵犯是否会导致更差的预后尚不清楚。
确定了254例OCSCC患者，并将其分为3组：（1）肿瘤直径≤4 cm且无骨侵犯；（2）肿瘤直径≤4 cm且有骨侵犯；（3）肿瘤直径≥4 cm或有其他因素（如皮肤侵犯、深部肌肉侵犯），除骨侵犯外符合美国癌症联合委员会（AJCC）T4分类标准。还记录了骨侵犯的深度（无、皮质或髓质）。
第1组和第2组的预后相似。第3组的区域控制率（p = 0.04）、疾病特异性生存率（DSS；p < 0.01）和总生存率（OS；p < 0.01）较低。多因素分析显示，切缘状态和髓质骨侵犯与较差的预后相关。
对于接受手术/放疗的小原发性肿瘤患者，骨侵犯似乎不会显著影响预后。髓质骨侵犯似乎会导致控制率和生存率降低。
