Zhang Yong-xia, Zhang Bin, Gao Li, Xu Zhen-gang, Tang Ping-zhang
Department of Head and Neck Surgery, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 May;48(5):398-404.
To investigate the clinicopathological features, treatment outcomes and prognosis of patients with oropharyngeal squamous cell carcinoma (OSCC).
Retrospective review of 318 consecutive cases with OSCC treated from January 1999 to December 2011. Survival rates and prognostic factors were calculated using the Kaplan-Meier method and multivariate Cox model survival analysis respectively. There were 281 males and 37 females, with a median age of 56 years. Of the 318 cases, 163 carcinomas were from tonsil, 108 from tongue base and 47 from soft palate-uvula. The presenting symptoms were pharyngalgia (128 cases, 40.3%), neck masses (71 cases, 22.3%), foreign body sensation in the pharynx (63 cases, 19.8%) and dental ulcer (44 cases, 13.8%). The median time from onset of the first symptoms until diagnosis of OSCC was 3 months. Of the 318 OSCC, 75 were with high grade, 110 with intermediate grade and 133 with low grade, including 10 patients at stageI, 39 at stage II, 68 at stage III and 201 at stage IV.
The rates of lymph node metastasis, distant metastasis and second primary carcinoma were 72.3%, 13.2% and 7.9%, respectively. Of 318 patients, 117 received radiotherapy alone, 66 underwent surgery plus postoperative radiotherapy, 59 underwent preoperative radiotherapy plus surgery, 33 received concomitant chemotherapy and radiotherapy, 20 received concomitant molecular targeted therapy and radiotherapy, 16 underwent surgery alone and 7 received induction chemotherapy plus radiotherapy. The 3-, 5-year overall survival (OS) rates were 58.4%, 50.7%, respectively, and the median overall survival time was 60.1 months. Ages (P = 0.034), gender(P = 0.024), smoking and alcohol consumptions(P = 0.008), doses of radiotherapy(P = 0.046) and clinic stages(P = 0.001) were independent factors for OS.
OSCC is poor in prognosis, with a high incidence of cervical lymph node metastasis. Radiotherapy and salvage surgery are the main treatments for OSCC.
探讨口咽鳞状细胞癌（OSCC）患者的临床病理特征、治疗效果及预后。
回顾性分析1999年1月至2011年12月连续收治的318例OSCC患者。分别采用Kaplan-Meier法和多因素Cox模型生存分析计算生存率和预后因素。其中男性281例，女性37例，中位年龄56岁。318例患者中，163例癌灶位于扁桃体，108例位于舌根，47例位于软腭-悬雍垂。主要症状为咽痛（128例，40.3%）、颈部肿块（71例，22.3%）、咽部异物感（63例，19.8%）和口腔溃疡（44例，13.8%）。从首发症状出现至确诊OSCC的中位时间为3个月。318例OSCC中，高分化75例，中分化110例，低分化133例，其中Ⅰ期10例，Ⅱ期39例，Ⅲ期68例，Ⅳ期201例。
淋巴结转移率、远处转移率和第二原发癌发生率分别为72.3%、13.2%和7.9%。318例患者中，117例单纯接受放疗，66例接受手术加术后放疗，59例接受术前放疗加手术，33例接受同步放化疗，20例接受同步分子靶向治疗和放疗，16例单纯接受手术，7例接受诱导化疗加放疗。3年、5年总生存率（OS）分别为58.4%、50.7%，中位总生存时间为60.1个月。年龄（P = 0.034）、性别（P = 0.024）、吸烟和饮酒（P = 0.008）、放疗剂量（P = 0.046）和临床分期（P = 0.001）是影响OS的独立因素。
OSCC预后较差，颈部淋巴结转移发生率高。放疗和挽救性手术是OSCC的主要治疗方法。
