Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland.
Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland.
Int J Oral Maxillofac Surg. 2019 Jul;48(7):851-856. doi: 10.1016/j.ijom.2019.01.008. Epub 2019 Feb 7.
This study was performed to report the outcomes of patients with oral squamous cell carcinoma (OSCC) of the tongue over a 10-year period with the aim of testing the hypothesis that the lymph node ratio (LNR) has a significant influence on loco-regional recurrence. The charts of 227 patients with OSCC of the mobile tongue treated at the University Hospital of Zurich from 2003 to 2012 were screened. Following the application of the exclusion criteria (prior chemotherapy, radiotherapy, or surgery, perioperative death, N3 disease, unresectable disease, synchronous second primary, no signed informed consent, and follow-up <3years), prospective data were collected and a retrospective analysis performed for 88 of these patients who were treated with selective neck dissection. During a mean follow-up period of 78 months (standard deviation 37 months), loco-regional recurrence was diagnosed in 25 patients (28%). The overall and disease-specific survival rates for the study population were 72% and 80%, respectively. Perineural invasion was identified as an independent risk factor for decreased disease-specific survival, whereas LNR was not. LNR did not show an influence on disease recurrence. Thus, its prognostic value in patients with tongue cancer remains uncertain and the decision regarding adjuvant therapy should not be made solely on the basis of LNR.
本研究旨在报告舌口腔鳞状细胞癌（OSCC）患者在 10 年内的治疗结果，以检验假设，即淋巴结比率（LNR）对局部区域复发有显著影响。筛选了 2003 年至 2012 年在苏黎世大学医院接受治疗的 227 例移动舌 OSCC 患者的图表。应用排除标准（先前的化疗、放疗或手术、围手术期死亡、N3 疾病、不可切除的疾病、同步第二原发疾病、未签署知情同意书和随访<3 年）后，对其中 88 例接受选择性颈淋巴结清扫术的患者进行了前瞻性数据收集和回顾性分析。在平均 78 个月（标准差 37 个月）的随访期间，25 例患者（28%）被诊断为局部区域复发。该研究人群的总生存率和疾病特异性生存率分别为 72%和 80%。神经周围侵犯被确定为疾病特异性生存率降低的独立危险因素，而 LNR 不是。LNR 并未显示对疾病复发有影响。因此，其在舌癌患者中的预后价值仍不确定，辅助治疗的决策不应仅基于 LNR。
