Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Laryngoscope. 2014 Jun;124(6):1386-91. doi: 10.1002/lary.24496. Epub 2014 Mar 4.
OBJECTIVES/HYPOTHESIS: To determine whether buccal squamous cell carcinoma has worse overall survival (OS) and disease-specific survival (DSS) than cancers in the rest of the oral cavity.
Retrospective analysis of a large population database.
We began with a Kaplan-Meier analysis of OS and DSS for buccal versus nonbuccal tumors with unmatched data, followed by an analysis of cases matched for race, age at diagnosis, stage at diagnosis, and treatment modality. This was supported by a univariate Cox regression comparing buccal cancer to nonbuccal cancer, followed by a multivariate Cox regression that included all significant variables studied.
With unmatched data, buccal cancer had significantly lesser OS and DSS values than cancers in the rest of the oral cavity (P < .001). After case matching, the differences between OS and DSS for buccal cancer versus nonbuccal oral cancer were no longer significant. Univariate Cox regression models with respect to OS and DSS showed a significant difference between buccal cancer and nonbuccal cancer. However, with multivariate analysis, buccal hazard ratios for OS and DSS were not significant.
With the largest series of buccal carcinoma to date, our study concludes that the OS and DSS of buccal cancer are similar to those of cancers in other oral cavity sites once age at diagnosis, tumor stage, treatment, and race are taken into consideration. The previously perceived poor prognosis of buccal carcinoma may be due to variations in tumor presentation, such as later stage and older patient age.
2b.
目的/假设：确定颊部鳞状细胞癌的总生存率（OS）和疾病特异性生存率（DSS）是否比口腔其他部位的癌症差。
回顾性分析大型人群数据库。
我们首先对 OS 和 DSS 进行 Kaplan-Meier 分析，比较了未匹配数据的颊部和非颊部肿瘤，然后对种族、诊断时年龄、诊断时分期和治疗方式相匹配的病例进行分析。这得到了一个单变量 Cox 回归的支持，该回归比较了颊部癌症与非颊部癌症，然后进行了一个多变量 Cox 回归，其中包括了所有研究的显著变量。
在未匹配数据中，颊部癌症的 OS 和 DSS 值明显低于口腔其他部位的癌症（P < .001）。在病例匹配后，颊部癌症与非颊部口腔癌症的 OS 和 DSS 之间的差异不再显著。关于 OS 和 DSS 的单变量 Cox 回归模型显示颊部癌症与非颊部癌症之间存在显著差异。然而，在多变量分析中，颊部癌症的 OS 和 DSS 的风险比没有显著意义。
在迄今为止最大的颊部癌系列研究中，我们的研究得出结论，考虑到诊断时的年龄、肿瘤分期、治疗和种族，颊部癌症的 OS 和 DSS 与口腔其他部位的癌症相似。以前认为颊部癌预后较差的原因可能是肿瘤表现的差异，如晚期和老年患者。
2b。
