Ren Zhen-Hu, Wu Han-Jiang, Zhang Sheng, Wang Kai, Gong Zhao-Jian, He Zhi-Jing, Peng Jie
Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China; Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, Hunan, 410011, China.
Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, No. 139 Renmin Road, Changsha, Hunan, 410011, China.
J Craniomaxillofac Surg. 2015 Oct;43(8):1577-82. doi: 10.1016/j.jcms.2015.07.034. Epub 2015 Aug 5.
This study characterized the infiltration of primary tumors along the intrinsic and extrinsic muscles of the tongue in oral tongue squamous cell carcinoma (OTSCC), to create a new surgical strategy that is suitable for most stages. A preliminary evaluation of this novel surgical approach was also conducted.
An anatomic study of macroscopic specimens from 10 human cadavers and 100 OTSCC patients was conducted. The anatomic characteristics of the primary tumors and the origin and distribution of fibers of the intrinsic and extrinsic tongue muscles were observed and measured. After initial treatment with curative intent, the 100 patients were regularly followed-up with clinical examination and imaging.
Based on the anatomic characteristics of the primary tumors and tongue muscles, a new surgical approach was developed, and was described as muscle anatomy tongue surgery (MATS). MATS proved suitable for almost all stages of OTSCC. According to the morphology of the invasive tumor front, the 100 cases were divided into four types. The rate of 2-year local disease control was 98%, locoregional control 86%, disease-free survival 85%, and overall survival 89%. Tongue functions were perfectly recovered in more than 60% of the patients.
Application of the principles of MATS to the treatment of OTSCC proved suitable for almost all stages of the disease. MATS is a novel surgical technique that may improve outcomes in tongue cancer surgery.
本研究对口腔舌鳞状细胞癌（OTSCC）中原发肿瘤沿舌内、外肌的浸润情况进行了特征分析，以制定一种适用于大多数分期的新手术策略。还对这种新型手术方法进行了初步评估。
对10例人体尸体和100例OTSCC患者的宏观标本进行了解剖学研究。观察并测量了原发肿瘤的解剖特征以及舌内、外肌纤维的起源和分布。对这100例患者进行根治性初始治疗后，定期进行临床检查和影像学随访。
根据原发肿瘤和舌肌的解剖特征，开发了一种新的手术方法，称为肌肉解剖舌手术（MATS）。MATS被证明适用于几乎所有分期的OTSCC。根据浸润肿瘤前沿的形态，将100例病例分为四种类型。2年局部疾病控制率为98%，局部区域控制率为86%，无病生存率为85%，总生存率为89%。超过60%的患者舌功能完全恢复。
将MATS原则应用于OTSCC的治疗被证明适用于该疾病的几乎所有分期。MATS是一种新型手术技术，可能会改善舌癌手术的疗效。
