Kao Huang-Kai, Abdelrahman Mohamed, Huang Yenlin, Tsai Chia-Hsuan, Barrera Megias J, Tsang Ngan-Ming, Couves Adam J, Cheng Ming-Huei, Chang Kai-Ping
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan.
J Surg Oncol. 2017 Jun;115(7):835-841. doi: 10.1002/jso.24600. Epub 2017 Mar 20.
Little is known about the appropriate treatment and long-term survival of patients with multiple concomitant oral cavity cancers (MOC). The aim of this study was to clarify the clinicopathological features of MOC, to compare the prognosis of MOC patients with that of patients with single oral cavity cancers (SOC), and to describe reconstructive options based on the concept of economy in autologous tissue transfer.
Data from 603 patients diagnosed with at least one squamous cell carcinoma of the oral cavity who underwent surgery for primary oral cavity cancers between 2006 and 2014 were reviewed retrospectively to identify MOC patients.
Among 603 cases of surgically resected primary oral cancers, 20 cases (3.3%) with MOC were identified. Patients with MOC did not differ from patients with SOC in age, and their index lesions did not differ in pT value, pN value, pathological stage, extracapsule spread, or perineural or bone invasion. The 5-year overall and disease-free survival rates for MOC and SOC cases were 72.6% versus 68.7%, and 65.3% versus 64.8%, respectively (P = 0.785 and 0.770, respectively). The anterolateral thigh flap was widely applied. According to its origin of blood supply, the reconstructive options of MOC patients with separated defects were classified and proposed.
MOC and SOC were similar in clinicopathological characteristics. The prognosis of patients with MOC was similar to that of patients with SOC. Resections were performed with curative intent. A multidisciplinary team management approach is essential for customized treatment in MOC patients.
对于多灶性口腔癌（MOC）患者的恰当治疗及长期生存情况，人们了解甚少。本研究旨在阐明MOC的临床病理特征，比较MOC患者与单灶性口腔癌（SOC）患者的预后，并基于自体组织移植的经济性概念描述重建方案。
回顾性分析2006年至2014年间因原发性口腔癌接受手术治疗的603例至少诊断出一处口腔鳞状细胞癌患者的数据，以确定MOC患者。
在603例手术切除的原发性口腔癌病例中，确定了20例（3.3%）MOC患者。MOC患者与SOC患者在年龄上无差异，其指数病灶在pT值、pN值、病理分期、包膜外扩散、神经周围或骨侵犯方面也无差异。MOC和SOC病例的5年总生存率和无病生存率分别为72.6%对68.7%，以及65.3%对64.8%（P分别为0.785和0.770）。股前外侧皮瓣得到广泛应用。根据血供来源，对缺损分离的MOC患者的重建方案进行了分类并提出。
MOC和SOC在临床病理特征方面相似。MOC患者的预后与SOC患者相似。手术切除具有根治意图。多学科团队管理方法对于MOC患者的个体化治疗至关重要。
