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口腔癌手术后的生存情况:30年经验总结

Survival after surgery for oral cancer: a 30-year experience.

作者信息

Ong T K, Murphy C, Smith A B, Kanatas A N, Mitchell D A

机构信息

Leeds Teaching Hospitals.

York Health Economics Consortium, University of York.

出版信息

Br J Oral Maxillofac Surg. 2017 Nov;55(9):911-916. doi: 10.1016/j.bjoms.2017.08.362. Epub 2017 Sep 13.

Abstract

Oral squamous cell carcinoma is the most common intraoral malignancy, for which we advocate radical primary resection with adjuvant treatment where indicated. The main aims of this paper are to identify the overall survival of a consecutive series of patients and to relate survival to clinical and pathological factors. Kaplan-Meier curves were produced for site, sex, TNM status, and use of postoperative radiotherapy. The data were analysed using IBM SPSS Statistics for Windows and probabilities of less than 0.05 were accepted as significant. A total of 921 patients were recorded in the database with a diagnosis of oral squamous cell carcinoma out of a total of 1958 with salivary gland conditions or other cancers of the head and neck (43.1%). The earliest date of diagnosis was 1973, and the data were censored at 31 March 2016. The database comprised 340 women (36.9%) and 581 men (63.1%). A total of 339 patients died (34.5%): 117 women (33.7%) and 222 men (65.5%). The mean (range) age at death was 73.4 (31.4-97.5) years for women and 68.7 (33.3-95.5) years for men (t (337)=3.28, p=0.001). Our overall survival was somewhat better than the 56% five-year survival reported for oral cancer in England in 2010, which may be a reflection of the treatment. This work supports the view that aggressive management may improve overall survival.

摘要

口腔鳞状细胞癌是最常见的口腔恶性肿瘤,对此我们主张在有指征时进行根治性原发灶切除并辅以辅助治疗。本文的主要目的是确定一系列连续患者的总生存率,并将生存率与临床和病理因素相关联。针对病变部位、性别、TNM分期以及术后放疗的使用情况绘制了Kaplan-Meier曲线。使用IBM SPSS Statistics for Windows对数据进行分析,概率小于0.05被视为具有显著性。数据库中总共记录了921例诊断为口腔鳞状细胞癌的患者,占1958例唾液腺疾病或其他头颈部癌症患者的43.1%。最早的诊断日期为1973年,数据截至2016年3月31日。数据库包括340名女性(36.9%)和581名男性(63.1%)。共有339例患者死亡(34.5%):117名女性(33.7%)和222名男性(65.5%)。女性死亡时的平均(范围)年龄为73.4(31.4 - 97.5)岁,男性为68.7(33.3 - 95.5)岁(t(337)=3.28,p = 0.001)。我们的总生存率略高于2010年英国报道的口腔癌56%的五年生存率,这可能反映了治疗效果。这项工作支持积极治疗可能提高总生存率的观点。

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