Blanchard P, El Khoury C, Temam S, Casiraghi O, Mirghani H, Lévy A, Gorphe P, Éven C, De Felice F, Nguyen F, Janot F, Tao Y
Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Cancer Radiother. 2016 Apr;20(2):91-7. doi: 10.1016/j.canrad.2015.09.013. Epub 2016 Mar 8.
Squamous cell carcinomas of the oral cavity occurring in young people represent a specific entity. Its management and prognosis are controversial. We performed a retrospective chart review of all patients aged less than 40 years old and treated at Gustave-Roussy Cancer Centre for a squamous cell carcinomas of the oral cavity between 1999 and 2011.
Patients and tumour characteristics, type of treatment and follow-up data were collected. Survival data were analysed according to the methods of Kaplan-Meier and both univariate and multivariate analyses were performed to look for prognostic factors regarding overall survival and progression-free survival.
Sixty-three patients were identified. Median follow-up was 64 months. Most of the tumours were initially located in the mobile tongue (n=54, 85.7%). Overall 17 patients had died, including 15 from the treated cancer. Overall and progression-free survival rates at 5 years were respectively 79.6% and 68.6%. The corresponding 5 years local, regional and metastatic relapse free survival rates were 80%, 91% and 89% respectively. In the multivariate analysis only the absence of initial surgery (hazard ratio [HR]: 13.5 [2.0; 90.5]; P=0.007) was prognostic for overall survival, while alcohol abuse (HR: 0.37 [0.15; 0.9]; P=0.03) and the absence of surgery (HR: 13.6 [2.5; 74.2]; P=0.002) were associated with a decreased progression-free survival. A younger age (less than 30 year old) was not associated with the risk of recurrence or death.
Survival rates and tumour control probabilities are relatively high among young patients suffering from squamous cell carcinomas of the oral cavity treated at a tertiary centre. The early identification of patients at risk of relapse is currently difficult. The balance between recurrence and treatment toxicity warrants further studies, both on the clinical level and for the development of prognostic biomarkers.
发生于年轻人的口腔鳞状细胞癌是一种特殊的实体肿瘤。其治疗和预后存在争议。我们对1999年至2011年间在古斯塔夫 - 鲁西癌症中心接受治疗的所有年龄小于40岁的口腔鳞状细胞癌患者进行了回顾性病历审查。
收集患者和肿瘤特征、治疗类型及随访数据。根据Kaplan - Meier方法分析生存数据，并进行单因素和多因素分析以寻找总生存和无进展生存的预后因素。
共确定63例患者。中位随访时间为64个月。大多数肿瘤最初位于活动舌部（n = 54，85.7%）。总体上17例患者死亡，其中15例死于所治疗的癌症。5年总生存率和无进展生存率分别为79.6%和68.6%。相应的5年局部、区域和远处无复发生存率分别为80%、91%和89%。多因素分析中，仅未进行初始手术（风险比[HR]：13.5 [2.0; 90.5]; P = 0.007）对总生存具有预后意义，而酗酒（HR：0.37 [0.15; 0.9]; P = 0.03）和未进行手术（HR：13.6 [2.5; 74.2]; P = 0.002）与无进展生存降低相关。较年轻的年龄（小于30岁）与复发或死亡风险无关。
在三级中心接受治疗的年轻口腔鳞状细胞癌患者中，生存率和肿瘤控制概率相对较高。目前难以早期识别有复发风险的患者。复发与治疗毒性之间的平衡值得在临床层面以及预后生物标志物的开发方面进行进一步研究。
