接受手术治疗的口腔鳞状细胞癌患者远处转移的危险因素

Risk Factors for Distant Metastasis in Patients with Oral Cavity Squamous Cell Carcinoma Undergoing Surgical Treatment.

作者信息

Aires Felipe Toyama, Lin Chin Shien, Matos Leandro Luongo, Kulcsar Marco Aurélio Vamondes, Cernea Claudio Roberto

机构信息

Department of Head and Neck Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.

Department of Head and Neck Surgery, Instituto do Cancer do Estado de São Paulo (ICESP), São Paulo, Brazil.

出版信息

ORL J Otorhinolaryngol Relat Spec. 2017;79(6):347-355. doi: 10.1159/000485627. Epub 2018 Jan 23.

DOI:10.1159/000485627

PMID:29393250

Abstract

OBJECTIVE

The aim of this study is to investigate the clinical and pathological factors related to distant metastasis in patients with oral cavity squamous cell carcinoma (OCSCC) undergoing surgery.

STUDY DESIGN

A retrospective data review was conducted on patients who underwent primary surgery for OCSCC at the Instituto do Cancer do Estado de São Paulo (ICESP) between 2009 and 2015. Distant metastasis rates were calculated and predictive factors were determined by the Cox proportional-hazards model.

RESULTS

There was a total of 274 patients, including 210 (76.6%) men and 64 (23.4%) women, with a mean age of 59.9 ± 10.9 years. The incidence of distant metastasis was 9.6%, with the lung being the most common site. The mean time interval between surgical treatment and the diagnosis of distant metastasis was 12 months (range 2-40 months). In the multivariate analysis, angiolymphatic invasion (HR = 2,87; p = 0.023), contralateral cervical metastasis (HR = 3.3; p = 0,007), tumor thickness >25 mm (HR = 3.50; p = 0.009), and locoregional recurrence (HR = 6.59; p < 0.0001) were the only independent risk factors for distant metastasis.

CONCLUSION

Patients with OCSCC who have contralateral lymph node metastasis, tumors with a thickness >25 mm, angiolymphatic invasion, or locoregional recurrence after surgical treatment have a greater risk of developing distant metastasis.

摘要

目的

本研究旨在调查接受手术治疗的口腔鳞状细胞癌（OCSCC）患者远处转移的临床和病理因素。

研究设计

对2009年至2015年期间在圣保罗州癌症研究所（ICESP）接受OCSCC初次手术的患者进行回顾性数据审查。计算远处转移率，并通过Cox比例风险模型确定预测因素。

结果

共有274例患者，其中男性210例（76.6%），女性64例（23.4%），平均年龄59.9±10.9岁。远处转移发生率为9.6%，肺是最常见的转移部位。手术治疗与远处转移诊断之间的平均时间间隔为12个月（范围2 - 40个月）。在多变量分析中，血管淋巴管浸润（HR = 2.87；p = 0.023）、对侧颈部转移（HR = 3.3；p = 0.007）、肿瘤厚度>25 mm（HR = 3.50；p = 0.009）和局部区域复发（HR = 6.59；p < 0.0001）是远处转移的唯一独立危险因素。