Cariati Paolo, Cabello Serrano Almudena, Roman Ramos Maria, Sanchez Lopez Dario, Fernandez Solis Jose, Martinez Lara Ildefonso
Hospital Virgen de las Nieves, Granada, Spain.
Hospital Virgen de las Nieves, Granada, Spain.
Acta Otorrinolaringol Esp (Engl Ed). 2019 Mar-Apr;70(2):68-73. doi: 10.1016/j.otorri.2018.02.007.
The main aim of the present report is to study the behavior of SCC of the floor of the mouth.
A retrospective analysis was conducted using the records of patients diagnosed with squamous cell carcinoma of the floor of the mouth between 2000 and 2012 in the HUVN. Ninety-three patients with squamous cell carcinoma of the floor of the mouth treated with tumourectomy and selective neck dissection were included in the study. The pattern of distribution of cervical metastases and numerous histological features such as T-stage, N stage, surgical margins, tumor thickness, ECS (extracapsular spread) and vascular invasion were analyzed.
Level I was the most affected level, followed by Level II. T stage, tumor thickness, and surgical margins showed a strong relationship with the risk of developing a local or cervical failure at follow-up. Overall survival was 52.7%. T stage, tumor thickness, N stage, recurrence, extracapsular spread, and vascular invasion were also associated with a poor prognosis.
SCC of the floor of the mouth is an aggressive disease even at early stages. Due to the low rate of positive nodes observed at level IV and V in clinically N0 patients, supraomohyoid neck dissection might be considered sufficiently safe in this group.
本报告的主要目的是研究口腔底部鳞状细胞癌的行为。
使用2000年至2012年在HUVN诊断为口腔底部鳞状细胞癌的患者记录进行回顾性分析。纳入93例接受肿瘤切除术和选择性颈清扫术治疗的口腔底部鳞状细胞癌患者。分析了颈部转移的分布模式以及众多组织学特征，如T分期、N分期、手术切缘、肿瘤厚度、包膜外扩散（ECS）和血管侵犯。
I级是受影响最严重的级别，其次是II级。T分期、肿瘤厚度和手术切缘与随访时发生局部或颈部失败的风险密切相关。总生存率为52.7%。T分期、肿瘤厚度、N分期、复发、包膜外扩散和血管侵犯也与预后不良相关。
即使在早期阶段，口腔底部鳞状细胞癌也是一种侵袭性疾病。由于临床N0患者IV级和V级的阳性淋巴结率较低，在该组中可认为肩胛舌骨上颈清扫术足够安全。
