Nishi Hideaki, Shinozaki Takeshi, Tomioka Toshifumi, Maruo Takashi, Hayashi Ryuichi
Department of Otolaryngology, Sasebo City General Hospital, 9-3 Hirasemachi, Sasebo, Nagasaki, 857-8511, Japan; Department of Head and Neck Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Department of Head and Neck Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Auris Nasus Larynx. 2018 Apr;45(2):337-342. doi: 10.1016/j.anl.2017.05.011. Epub 2017 Jun 16.
Squamous cell carcinoma (SCC) of the retromolar trigone is uncommon, accounting for 1.4% of all oral cancer cases in Japan. Few studies have examined the optimal treatment for this cancer. The aim of this study was to evaluate the outcome of treatment for primary SCC of the retromolar area.
We retrospectively analyzed the outcome and prognosis of 45 patients (38 men, 7 women) with SCC of the retromolar trigone who underwent treatment in our department between July 1992 and March 2011.
Mean age was 62.4 years. Clinical stages were: stage I (n=4, 8.9%); stage II (n=10, 22.2%); stage III (n=5, 11.1%); and stage IVa (n=26, 57.8%). Surgical resection was performed in all patients and 6 patients also received postoperative radiotherapy. Reconstructive surgery using free flaps was performed in 38 patients; postoperative complications occurred in 5 of these patients. The 3-year local control rate was 80%, and the 3-year over all survival rates for stage I, II, III, and IV disease were 100%, 80%, 40%, and 49.2%, respectively. Cause of death was the original disease in 23 cases and other diseases in 2 cases. The most common cause of death from the original disease was cervical lymph node metastasis.
The presence of cervical lymph node metastasis was a negative prognostic factor. Marginal mandibulectomy may be selected for patients without distinct bone-marrow infiltration.
磨牙后三角区鳞状细胞癌（SCC）并不常见，在日本占所有口腔癌病例的1.4%。很少有研究探讨这种癌症的最佳治疗方法。本研究的目的是评估磨牙后区原发性SCC的治疗结果。
我们回顾性分析了1992年7月至2011年3月在我科接受治疗的45例磨牙后三角区SCC患者（38例男性，7例女性）的治疗结果和预后。
平均年龄为62.4岁。临床分期为：I期（n = 4，8.9%）；II期（n = 10，22.2%）；III期（n = 5，11.1%）；IVa期（n = 26，57.8%）。所有患者均接受了手术切除，6例患者还接受了术后放疗。38例患者采用游离皮瓣进行了重建手术；其中5例患者出现了术后并发症。3年局部控制率为80%，I、II、III和IV期疾病的3年总生存率分别为100%、80%、40%和49.2%。死亡原因中，23例为原发病，2例为其他疾病。原发病最常见的死亡原因是颈部淋巴结转移。
颈部淋巴结转移的存在是一个负面预后因素。对于没有明显骨髓浸润的患者，可选择下颌骨边缘切除术。
