Gokavarapu Sandhya, Parvataneni Nagendra, Pavagada Sreenivasa, Chandrasekhara Rao L M, Raju K V, Rao T Subramaneshwar
Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.
Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Mar;123(3):330-337. doi: 10.1016/j.oooo.2016.10.028. Epub 2016 Nov 16.
The objective of this study was to investigate the significance of mild and moderate dysplasia at the surgical margin with regard to survival and locoregional recurrence.
We investigated cases of primary oral squamous cell carcinoma with negative margins retrospectively from the database of a tertiary cancer hospital. All patients had been treated between January 2010 and December 2012, and margin dysplasia was investigated in a multivariate analysis for locoregional recurrence and overall survival.
Of a total of 425 patients who fulfilled the inclusion criteria, 28 patients had mild dysplasia, and 29 patients had moderate dysplasia; median period of follow-up was 46.63 ± 10.04 (standard deviation) months. Most of the patients with mild and moderate dysplasia in the margin were tobacco users (P = .007). Univariate analysis showed lower rates of survival among the patients with margin dysplasia (mild + moderate) (P = .043), and the multivariate cox regression revealed moderate dysplasia at the margin as an independent significant factor for survival (P < .0001) when adjusted with other cofounders.
Patients with mild or moderate dysplasia at surgical margin were often tobacco users, and moderate dysplasia in the margin is an independent significant indicator for survival of patients with oral cancer in this single-institution, retrospective study.
本研究的目的是探讨手术切缘轻度和中度发育异常对于生存及局部区域复发的意义。
我们从一家三级癌症医院的数据库中回顾性调查了手术切缘阴性的原发性口腔鳞状细胞癌病例。所有患者均在2010年1月至2012年12月期间接受治疗,并对切缘发育异常进行多因素分析,以评估局部区域复发和总生存情况。
在总共425例符合纳入标准的患者中,28例有轻度发育异常,29例有中度发育异常;中位随访期为46.63±10.04(标准差)个月。切缘有轻度和中度发育异常的患者大多为吸烟者(P = 0.007)。单因素分析显示切缘发育异常(轻度+中度)患者的生存率较低(P = 0.043),多因素Cox回归分析显示,在与其他混杂因素校正后,切缘中度发育异常是生存的独立显著因素(P < 0.0001)。
在这项单机构回顾性研究中,手术切缘有轻度或中度发育异常的患者常为吸烟者,切缘中度发育异常是口腔癌患者生存的独立显著指标。