1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California, USA.
2 Head and Neck Cancer Program, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2018 Jul;159(1):51-58. doi: 10.1177/0194599818756815. Epub 2018 Feb 13.
Objective To describe the determinants of survival for patients with floor of mouth (FOM) squamous cell carcinoma (SCC) from 1973 to 2013 with the SEER database (Surveillance, Epidemiology, and End Results). Study Design and Setting Retrospective cohort study with a national database. Subjects and Methods The SEER registry was utilized to calculate survival trends for patients with FOM SCC between 1973 and 2013. Patient data were analyzed with respect to age, sex, race, primary site, stage at presentation, tumor size, grade, and treatment modalities (surgery and radiotherapy). Overall survival (OS) and disease-specific survival (DSS) were calculated. Results A total of 14,010 FOM SCC cases were identified. The cohort was 69.5% male, and the median age at diagnosis was 62 years. Forty-six percent of cases were treated with surgery, while 14% received radiotherapy. Kaplan-Meier analysis demonstrated OS and DSS of 39% and 59% at 5 years, respectively. Multivariate analysis showed that age, grade, stage, size, and surgery were determinants for OS and DSS (all P < .05). For early- and advanced-stage cancers, age, grade, size, and surgery predicted OS and DSS, while radiotherapy was a predictor of OS and DSS in advanced-stage tumors only (all P < .05). Conclusion To our knowledge, this study is the largest to date investigating prognostic factors for survival of patients diagnosed with FOM SCC. Determinants of survival include age, grade, stage, size, and surgery. Surgery appears to play a critical role in the management of these tumors.
利用 SEER 数据库（监测、流行病学和最终结果）描述 1973 年至 2013 年口腔底部（FOM）鳞状细胞癌（SCC）患者的生存决定因素。
回顾性队列研究，采用国家数据库。
利用 SEER 登记处计算 1973 年至 2013 年间 FOM SCC 患者的生存趋势。对患者数据进行分析，涉及年龄、性别、种族、原发部位、发病时的分期、肿瘤大小、分级和治疗方式（手术和放疗）。计算总生存（OS）和疾病特异性生存（DSS）。
共确定了 14010 例 FOM SCC 病例。队列中 69.5%为男性，中位诊断年龄为 62 岁。46%的病例接受手术治疗，14%接受放疗。Kaplan-Meier 分析显示，5 年时 OS 和 DSS 分别为 39%和 59%。多变量分析显示，年龄、分级、分期、大小和手术是 OS 和 DSS 的决定因素（均 P<.05）。对于早期和晚期癌症，年龄、分级、大小和手术预测 OS 和 DSS，而放疗仅在晚期肿瘤中是 OS 和 DSS 的预测因素（均 P<.05）。
据我们所知，这是迄今为止最大规模的研究，调查了口腔底部 SCC 患者生存的预后因素。生存的决定因素包括年龄、分级、分期、大小和手术。手术似乎在这些肿瘤的治疗中起着关键作用。
