Weber R S, Peters L J, Wolf P, Guillamondegui O
Department of Head and Neck Surgery, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030.
Otolaryngol Head Neck Surg. 1988 Jul;99(1):16-23. doi: 10.1177/019459988809900103.
This retrospective study concerns 188 patients with squamous cell carcinoma of the soft palate, uvula, and anterior faucial pillar treated for cure between 1970 and 1983. Men predominated in the group (1.9:1) and 55% of the patients were between 60 and 70 years old. Mean duration of followup was 56.7 months. TNM stage distribution was 29, 67, 37, and 49 patients for stages I, II, III, and IV respectively; six patients were unstaged because of previous excisional biopsy. Treatment to the primary site consisted of radiotherapy for 150 patients, surgery alone for 28 patients, and combined therapy for 10 patients. Primary control for T stages 1 through 4 was: 91% (31 of 34), 77% (71 of 92), 77% (30 of 39), and 35% (6 of 17), respectively. One hundred twenty-eight patients were N0 at presentation, as compared to 60 patients with regional nodal metastasis. Regional control was obtained in 87.5% of patients with N0 necks and in 76.7% of those with nodal involvement. In patients with primary control, these figures were 89% and 81%. Overall determinant survival was 80% at 2 years, but fell to 67% at 5 years. In addition to advanced tumor stage, the survival rate was reduced by regional lymph node metastasis. Tumor extension to the tongue base diminished survival. Survival was poorer among patients with midline tumors or tumors that extended across the palatine arch (37 patients) than for those with unilateral primary tumors (151 patients) (p less than 0.05). Despite similar T-stage distribution, the incidence of regional nodal metastasis was 49% in the former group, compared with 28% in the latter.(ABSTRACT TRUNCATED AT 250 WORDS)
这项回顾性研究涉及1970年至1983年间接受根治性治疗的188例软腭、悬雍垂和咽前柱鳞状细胞癌患者。该组中男性占主导（1.9:1），55%的患者年龄在60至70岁之间。平均随访时间为56.7个月。TNM分期分布为：I期29例、II期67例、III期37例、IV期49例；6例因先前切除活检而未分期。原发部位的治疗包括150例患者接受放疗，28例患者单独接受手术，10例患者接受联合治疗。T1至T4期的原发灶控制率分别为：91%（34例中的31例）、77%（92例中的71例）、77%（39例中的30例）和35%（17例中的6例）。128例患者初诊时为N0，相比之下，有60例患者有区域淋巴结转移。N0颈部患者的区域控制率为87.5%，有淋巴结受累的患者为76.7%。在原发灶得到控制的患者中，这些数字分别为89%和81%。总体决定性生存率在2年时为80%，但在5年时降至67%。除了肿瘤分期较晚外，区域淋巴结转移也降低了生存率。肿瘤延伸至舌根会降低生存率。中线肿瘤或延伸至腭弓的肿瘤患者（37例）的生存率低于单侧原发肿瘤患者（151例）（p<0.05）。尽管T分期分布相似，但前一组区域淋巴结转移的发生率为49%，而后一组为28%。（摘要截短于250字）
