累及上颌骨的口腔鳞状细胞癌：影响局部复发的因素及挽救性治疗对总生存的价值。
Oral squamous cell carcinoma involving the maxillae: Factors affecting local recurrence and the value of salvage treatment for overall survival.
作者信息
Slieker Fons J B, de Bree Remco, Van Cann Ellen M
机构信息
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Head Neck. 2020 Aug;42(8):1821-1828. doi: 10.1002/hed.26108. Epub 2020 Feb 26.
OBJECTIVE
To determine factors associated with local recurrence (LR) of oral squamous cell carcinoma involving the maxillae (MSCC) and overall survival (OS) after salvage treatment.
SUBJECTS AND METHODS
Retrospective study of MSCC operated between 2000 and 2015. Kaplan-Meier survival and Cox regression were used for analysis of MSCC-associated clinical and histopathological factors.
RESULTS
Ninety-five patients were included. LR occurred in 24% of patients. Vascular invasion significantly increased the risk of LR (hazard ratio 4.595, P = .003). Local salvage surgery, in the area of the original tumor, significantly prolonged OS, compared to palliative treatment (P = .001) and extensive salvage surgery (P = .013). Extensive salvage surgery, requiring resection of adjacent facial structures, did not prolong OS compared to palliative treatment (P = .186).
CONCLUSIONS
MSCC with vascular invasion has higher risk of LR. Salvage surgery may prolong OS in small recurrences but might have dubious value for larger recurrences infiltrating adjacent facial structures.
目的
确定与上颌骨口腔鳞状细胞癌（MSCC）局部复发（LR）及挽救性治疗后总生存期（OS）相关的因素。
对象与方法
对2000年至2015年间接受手术治疗的MSCC患者进行回顾性研究。采用Kaplan-Meier生存分析和Cox回归分析与MSCC相关的临床和组织病理学因素。
结果
纳入95例患者。24%的患者发生局部复发。血管侵犯显著增加局部复发风险（风险比4.595，P = 0.003）。与姑息治疗（P = 0.001）和广泛挽救性手术（P = 0.013）相比，在原发肿瘤区域进行局部挽救性手术显著延长总生存期。与姑息治疗相比，需要切除相邻面部结构的广泛挽救性手术并未延长总生存期（P = 0.186）。
结论
伴有血管侵犯的MSCC局部复发风险更高。挽救性手术可能会延长小复发灶患者的总生存期，但对于浸润相邻面部结构的较大复发灶可能价值存疑。
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