Loeffelbein D, Ritschl L M, Güll F D, Roth M, Wolff K-D, Mücke T
Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Int J Oral Maxillofac Surg. 2017 Apr;46(4):413-421. doi: 10.1016/j.ijom.2016.11.014. Epub 2016 Dec 19.
The successful treatment of oral squamous cell carcinoma (OSCC) depends on the treatment strategy. The prognosis is most often linked to the stage at initial presentation, but the effect of patient-related parameters on overall survival remains uncertain. In this study, 392 consecutive cases of OSCC seen between 2007 and 2013 at a single centre were analyzed retrospectively. Overall survival was assessed and univariate and multivariate Cox proportional hazards regression was used to identify associations between possible tumour-specific and patient-related variables and survival. The 5-year overall survival rate of the 392 patients (T stage 1-4) was 62.5%. Univariate analysis showed that sex, age, T stage, N stage, Union for International Cancer Control (UICC) stage, American Society of Anesthesiologists (ASA) status, operating time >400min, and length of in-patient stay >15 days were significantly associated with overall survival (all P<0.05). Tumour location, alcohol abuse, and smoking were found not to have a significant influence (all P>0.05). Age, T, N, and M stages, UICC stage, residual tumour status, recurrence, ASA status, and operating time >400min were found to have a significant influence on overall survival in the multivariate analysis (each P<0.05). These findings confirm that postoperative survival does not depend only on tumour-related characteristics. ASA status needs to be considered in treatment planning, as it significantly predicts patient survival.
口腔鳞状细胞癌（OSCC）的成功治疗取决于治疗策略。预后通常与初次就诊时的分期相关，但患者相关参数对总生存期的影响仍不确定。在本研究中，对2007年至2013年期间在单一中心连续诊治的392例OSCC病例进行了回顾性分析。评估总生存期，并采用单因素和多因素Cox比例风险回归分析来确定可能的肿瘤特异性和患者相关变量与生存期之间的关联。392例患者（T分期1 - 4期）的5年总生存率为62.5%。单因素分析显示，性别、年龄、T分期、N分期、国际癌症控制联盟（UICC）分期、美国麻醉医师协会（ASA）分级、手术时间>400分钟以及住院时间>15天与总生存期显著相关（均P<0.05）。肿瘤位置、酗酒和吸烟未发现有显著影响（均P>0.05）。多因素分析发现，年龄、T、N和M分期、UICC分期、肿瘤残留状态、复发、ASA分级以及手术时间>400分钟对总生存期有显著影响（各P<0.05）。这些发现证实，术后生存期不仅仅取决于肿瘤相关特征。在治疗规划中需要考虑ASA分级，因为它能显著预测患者的生存期。
