Department of Dentistry Unichristus, Rua João Adolfo Gurgel 133 Aldeota, 60160-196, Fortaleza, Ceará, Brazil
Med Oral Patol Oral Cir Bucal. 2020 May 1;25(3):e375-e382. doi: 10.4317/medoral.23410.
The objective of this study was to evaluate the influence of clinical-pathological and sociodemographic factors on the prevalence of distant metastasis (DM) and overall survival in patients with oral cavity and oropharynx squamous cell carcinoma (OOSCC).
Cross-sectional study based on the records of 404 OOSCC patients evaluated for DM, covering the period 2000-2014. We analysed the influence of age, sex, level of schooling, primary tumor subsite, treatment, marital status, family history of cancer, history of smoking and alcohol consumption, type of health care coverage (private vs. public) and overall survival. Findings were submitted to Fisher's exact test, Pearson's chi-squared test, Mantel-Cox log-rank testing and multinomial and Cox regression analysis (SPSS v. 20.0; p<0.05).
The prevalence of DM was 5.4% (22/404). The respiratory tract was the most affected DM site (n=9; 40.9%). Male sex (p=0.049), oropharyngeal primary tumor (p=0.008), stage T3-4 (p=0.022), lymph node metastasis (N+) (p<0.001) and palliative treatment (p=0.005) were directly associated with DM. Patients with oral primary tumours (p=0.343) and primary oropharyngeal tumours (p=0.242) did not differ significantly with regard to the prevalence of DM. N+ was an independent risk factor for DM (p=0.017). Five variables independently reduced overall survival: male sex (p=0.035), age >65 years (p=0.046), indigenous/brown racial type (p=0.045), palliative treatment (p=0.035) and DM (p=0.048).
Lymph node metastasis independently increased the prevalence of DM and, along with male sex, older age, brown racial type and palliative treatment, was independently associated with poor prognosis in patients with OOSCC.
本研究旨在评估临床病理和社会人口学因素对口腔和口咽鳞状细胞癌(OOSCC)患者远处转移(DM)和总生存率的影响。
这是一项基于 2000 年至 2014 年期间评估 DM 的 404 例 OOSCC 患者记录的回顾性研究。我们分析了年龄、性别、受教育程度、原发肿瘤部位、治疗、婚姻状况、家族癌症史、吸烟和饮酒史、医疗保险类型(私人与公共)以及总生存率对 DM 的影响。Fisher 确切检验、Pearson 卡方检验、Mantel-Cox 对数秩检验和多项及 Cox 回归分析(SPSS v. 20.0;p<0.05)用于分析结果。
DM 的患病率为 5.4%(22/404)。呼吸道是最易发生 DM 的部位(n=9;40.9%)。男性(p=0.049)、口咽原发肿瘤(p=0.008)、T3-4 期(p=0.022)、淋巴结转移(N+)(p<0.001)和姑息治疗(p=0.005)与 DM 直接相关。口腔原发肿瘤(p=0.343)和口咽原发肿瘤(p=0.242)患者的 DM 患病率无显著差异。N+是 DM 的独立危险因素(p=0.017)。5 个变量独立降低了总生存率:男性(p=0.035)、年龄>65 岁(p=0.046)、土着/棕色人种(p=0.045)、姑息治疗(p=0.035)和 DM(p=0.048)。
淋巴结转移独立增加了 DM 的患病率,与男性、年龄较大、棕色人种和姑息治疗一起,与 OOSCC 患者的不良预后独立相关。