术后放疗对深度浸润性口腔癌分期上调至 III 期的影响。
Impact of postoperative radiation therapy for deeply invasive oral cavity cancer upstaged to stage III.
机构信息
Department of Otolaryngology-Head and Neck Surgery, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
出版信息
Head Neck. 2019 May;41(5):1178-1183. doi: 10.1002/hed.25498. Epub 2019 Feb 18.
BACKGROUND
This article is about the eighth edition staging guidelines for upstaged patients with oral cavity squamous cell carcinoma (OCSCC) with >10 mm depth to pT3. This upstages some patients from stage I-II to stage III, a point at which patients are traditionally considered for postoperative radiation therapy (PORT). The role of PORT in patients upstaged for >10 mm depth is unknown.
METHODS
We identified patients with surgically resected stage I-II OCSCC with >10 mm depth who were upstaged to stage III. We used Cox proportional hazard modeling to compare patients who received PORT to those who did not (median follow-up 38.6 months).
RESULTS
We observed that 3.6% of patients with OCSCC were upstaged to stage III for depth >10 mm including 823 eligible patients. On adjusted analyses, PORT was associated with improved overall survival in patients upstaged to stage III (adjusted hazard ratio [aHR] 0.47, 95% confidence interval [CI] 0.30-0.73).
CONCLUSION
PORT is associated with improved survival for patients with OCSCC upstaged to stage III for >10 mm depth.
背景
本文介绍了口腔鳞状细胞癌（OCSCC）患者肿瘤浸润深度>10mm 时的第八版分期指南，这将使部分 I-II 期患者升级为 III 期，这些患者传统上被认为需要接受术后放疗（PORT）。对于因肿瘤浸润深度>10mm 而升级的患者，PORT 的作用尚不清楚。
方法
我们确定了手术切除的 I-II 期 OCSCC 患者中肿瘤浸润深度>10mm 而升级为 III 期的患者。我们使用 Cox 比例风险模型比较了接受 PORT 治疗的患者和未接受 PORT 治疗的患者（中位随访 38.6 个月）。
结果
我们发现，在肿瘤浸润深度>10mm 而升级为 III 期的 OCSCC 患者中，有 3.6%的患者被升级，其中包括 823 名符合条件的患者。在调整后的分析中，对于升级为 III 期的患者，PORT 与总生存改善相关（调整后的风险比[aHR]0.47，95%置信区间[CI]0.30-0.73）。
结论
对于因肿瘤浸润深度>10mm 而升级为 III 期的 OCSCC 患者，PORT 与生存改善相关。
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