口腔癌切除患者及同时性第二原发性恶性肿瘤患者的临床结局
Clinical Outcomes of Patients with Resected Oral Cavity Cancer and Simultaneous Second Primary Malignancies.
作者信息
Liao Chun-Ta, Fan Kang-Hsing, Kang Chung-Jan, Lin Chien-Yu, Chang Joseph Tung-Chieh, Tsang Ngan-Ming, Huang Bing-Shen, Chao Yin-Kai, Lee Li-Yu, Hsueh Chuen, Wang Hung-Ming, Liau Chi-Ting, Hsu Cheng-Lung, Hsieh Chia-Hsun, Ng Shu-Hang, Lin Chih-Hung, Tsao Chung-Kan, Fang Tuan-Jen, Huang Shiang-Fu, Chang Kai-Ping, Yen Tzu-Chen
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC; Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC; Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
出版信息
PLoS One. 2015 Sep 3;10(9):e0136918. doi: 10.1371/journal.pone.0136918. eCollection 2015.
OBJECTIVES
Simultaneous second primary tumors (SSPT) are not uncommon in patients with oral cavity squamous cell carcinoma (OSCC) living in areas where the habit of betel quid chewing is widespread. We sought to identify the main prognostic factors in OSCC patients with SSPT and incorporate them into a risk stratification scheme.
METHODS
A total of 1822 consecutive patients with primary OSCC treated between January 1996 and February 2014 were analyzed for the presence of SSPT. The 18-month and 5-year overall survival (OS) rates served as the main outcome measures.
RESULTS
Of the 1822 patients, 77 (4%) were found to have SSPT (i.e, two malignancies identified within one month of each other). The 18-month and 5-year OS rates in patients without SSPT and with SSPT were 82% and 69%, and 72% and 53%, respectively (p = 0.0063). Patients with SSPT were further divided into patients with either esophageal cancer or hepatocellular carcinoma (eso-HCC subgroup, n = 8) and other tumors (NO eso-HCC subgroup, n = 69). After multivariate analysis, neck nodal extracapsular spread (ECS, n = 18) and the presence of eso-HCC were identified as independent adverse prognostic factors. The 18-month OS rates of SSPT patients with both eso-HCC and ECS (n = 5) vs. the remaining patients (n = 72) were 0% and 78%, respectively (p < 0.0001).
CONCLUSION
OSCC patients with neck nodal ECS and esophageal cancer or hepatocellular carcinoma as SSPT have a dismal short-term prognosis.
目的
在槟榔咀嚼习惯普遍的地区，口腔鳞状细胞癌（OSCC）患者中同时发生的第二原发性肿瘤（SSPT）并不罕见。我们试图确定OSCC合并SSPT患者的主要预后因素，并将其纳入风险分层方案。
方法
分析了1996年1月至2014年2月期间连续治疗的1822例原发性OSCC患者是否存在SSPT。18个月和5年总生存率（OS）作为主要结局指标。
结果
在1822例患者中，77例（4%）被发现患有SSPT（即，在彼此一个月内确诊的两种恶性肿瘤）。无SSPT和有SSPT患者的18个月和5年OS率分别为82%和69%，以及72%和53%（p = 0.0063）。患有SSPT的患者进一步分为患有食管癌或肝细胞癌的患者（食管-肝细胞癌亚组，n = 8）和其他肿瘤患者（无食管-肝细胞癌亚组，n = 69）。多因素分析后，颈部淋巴结包膜外扩散（ECS，n = 18）和食管-肝细胞癌的存在被确定为独立的不良预后因素。同时患有食管-肝细胞癌和ECS的SSPT患者（n = 5）与其余患者（n = 72）的18个月OS率分别为0%和78%（p < 0.0001）。
结论
颈部淋巴结有ECS且同时患有食管癌或肝细胞癌作为SSPT的OSCC患者短期预后不佳。
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