美国唇鳞状细胞癌的流行病学：基于人群的队列分析。
Epidemiology of Squamous Cell Carcinoma of the Lip in the United States: A Population-Based Cohort Analysis.
机构信息
Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles.
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco Medical Center.
出版信息
JAMA Otolaryngol Head Neck Surg. 2016 Dec 1;142(12):1216-1223. doi: 10.1001/jamaoto.2016.3455.
IMPORTANCE
Squamous cell carcinoma of the lip (lip SCC) composes more than 25% of all oral cancers. Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series.
OBJECTIVE
To examine the incidence, treatment, overall survival, and disease-specific survival (DSS) of patients with lip SCC.
DESIGN, SETTING, AND PARTICIPANTS: Population-based cohort analysis using the Surveillance, Epidemiology, and End Results database identified patients with lip SCC between January 1, 1973, and December 31, 2012.
MAIN OUTCOMES AND MEASURES
Overall survival and DSS.
RESULTS
A total of 15 832 cases of lip SCC were identified. The cohort was composed of 12 945 men (81.8%) and 2887 women (18.2%). The mean age at diagnosis was 66.1 years. White patients accounted for 98.4% of the cases. Most of the tumors presented in the lower lip (77.8% external and 10.2% mucosal), whereas the external upper lip, mucosal upper lip, and the oral commissure represented 8%, 1%, and 1.2% of all cases, respectively. Of the patients, 91.2% underwent surgical therapy, 7.7% received radiation therapy, and 4.7% received both. Overall survival at 2 years, 5 years, and 10 years was 85.5%, 69.9%, and 50.2%, respectively. Multivariate analysis revealed that age, primary site, T stage, and N stage were determinants of overall survival and DSS. Kaplan-Meier survival analysis showed that SCC of the upper and lower lip had similar overall survival (163.6 months vs 163.8 months) and DSS (418.6 months vs 423.6 months). In contrast, SCC of the oral commissure had significantly lower overall survival (128.5 months) and DSS (286.7 months).
CONCLUSIONS AND RELEVANCE
Our study demonstrates that lip SCC predominantly affects white men in their mid-60s. The determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. Squamous cell carcinoma of the upper lip and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.
重要性
唇鳞状细胞癌（lip SCC）构成了所有口腔癌的 25%以上。大多数唇 SCC 的人口统计学和预后指标仅可通过回顾性病例系列获得。
目的
检查 lip SCC 患者的发病率、治疗、总生存率和疾病特异性生存率（DSS）。
设计、设置和参与者：使用监测、流行病学和最终结果数据库进行基于人群的队列分析，确定了 1973 年 1 月 1 日至 2012 年 12 月 31 日期间患有 lip SCC 的患者。
主要结果和措施
总生存率和 DSS。
结果
共确定了 15832 例 lip SCC 病例。该队列由 12945 名男性（81.8%）和 2887 名女性（18.2%）组成。诊断时的平均年龄为 66.1 岁。白人患者占病例的 98.4%。大多数肿瘤位于下唇（外部 77.8%，粘膜 10.2%），而上唇外部、上唇粘膜和口腔口角分别占所有病例的 8%、1%和 1.2%。91.2%的患者接受了手术治疗，7.7%接受了放疗，4.7%同时接受了放疗和化疗。2 年、5 年和 10 年的总生存率分别为 85.5%、69.9%和 50.2%。多变量分析显示，年龄、原发部位、T 分期和 N 分期是总生存率和 DSS 的决定因素。Kaplan-Meier 生存分析显示，上唇和下唇 SCC 的总生存率（163.6 个月对 163.8 个月）和 DSS（418.6 个月对 423.6 个月）相似。相比之下，口腔口角 SCC 的总生存率（128.5 个月）和 DSS（286.7 个月）明显较低。
结论和相关性
本研究表明，lip SCC 主要影响 60 多岁的白人男性。lip SCC 生存的决定因素包括诊断时的年龄、原发部位、T 分期和 N 分期。上唇和下唇的鳞状细胞癌的生存率相似，而口腔口角 SCC 则与生存率降低相关。
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