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525例接受口腔鳞状细胞癌手术患者的参数和结果。

Parameters and outcomes in 525 patients operated on for oral squamous cell carcinoma.

作者信息

Garzino-Demo P, Zavattero E, Franco P, Fasolis M, Tanteri G, Mettus A, Tosco P, Chiusa L, Airoldi M, Ostellino O, Schena M, Rampino M, Ricardi U, Evangelista A, Merletti F, Berrone S, Ramieri G

机构信息

Department of Maxillofacial Surgery, University of Turin, Turin, Italy.

Department of Maxillofacial Surgery, University of Turin, Turin, Italy.

出版信息

J Craniomaxillofac Surg. 2016 Sep;44(9):1414-21. doi: 10.1016/j.jcms.2016.06.007. Epub 2016 Jun 15.

Abstract

PURPOSE

This report analyzed the outcomes of patients undergoing surgery for oral squamous cell carcinoma (OSCC) to identify the value of prognostic factors.

MATERIAL AND METHODS

A total of 525 patients were studied who had undergone surgery for oral squamous cell carcinoma (OSCC) between 2000 and 2011, of whom 222 had received postoperative radiation-therapy (PORT) and or chemoradiation-therapy (PORTC). For each patient, personal data, histological findings, treatment and outcome were recorded and analyzed statistically. Survival curves were calculated using the Kaplan-Meier algorithm, and the difference in survival among subgroups was examined.

RESULTS

The overall survival (OS) and disease-specific survival (DSS) 5-year survival rate in the 525 patients were respectively 71.38% and 73.18%. The differences in the overall survival and disease-specific 5-year survival were significant (p < 0.05) for age < 40 years, site of origin, N status, staging, grading, osseous medullar infiltration, and perineural invasion. In patients undergoing radiation therapy, only perineural invasion negatively influenced the survival prognosis. In 150 pT1 cases of tongue and floor-of-mouth cancer, an infiltration depth (ID) > 4 mm was statistically correlated with poorer prognosis.

CONCLUSIONS

The results demonstrate an improvement in the 5-year OS and DSS rates during the past decade compared with the previous decade. Univariate analysis revealed that age, tumor staging, and lymph node involvement, extracapsular spread, grading, perineurial invasion, infiltration depth, and osseus medullary invasion were associated significantly with overall survival and disease-specific survival.

摘要

目的

本报告分析了接受口腔鳞状细胞癌(OSCC)手术患者的预后,以确定预后因素的价值。

材料与方法

共研究了2000年至2011年间接受口腔鳞状细胞癌(OSCC)手术的525例患者,其中222例接受了术后放疗(PORT)和/或放化疗(PORTC)。记录每位患者的个人数据、组织学检查结果、治疗情况及预后,并进行统计学分析。采用Kaplan-Meier算法计算生存曲线,检验亚组间生存率的差异。

结果

525例患者的总生存率(OS)和疾病特异性生存率(DSS)5年生存率分别为71.38%和73.18%。年龄<40岁、原发部位、N分期、临床分期、分级、骨髓浸润和神经周围浸润的总生存率和疾病特异性5年生存率差异有统计学意义(p<0.05)。在接受放疗的患者中,只有神经周围浸润对生存预后有负面影响。在150例舌癌和口底癌pT1病例中,浸润深度(ID)>4mm与较差的预后有统计学相关性。

结论

结果表明,与前十年相比,过去十年5年OS和DSS率有所提高。单因素分析显示,年龄、肿瘤分期、淋巴结受累、包膜外扩散、分级、神经周围浸润、浸润深度和骨髓浸润与总生存率和疾病特异性生存率显著相关。

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