Capote-Moreno A, Brabyn P, Muñoz-Guerra M F, Sastre-Pérez J, Escorial-Hernandez V, Rodríguez-Campo F J, García T, Naval-Gías L
Oral and Maxillofacial Surgery Department, University Hospital "La Princesa", Universidad Autónoma de Madrid, Madrid, Spain.
Oral and Maxillofacial Surgery Department, University Hospital "La Princesa", Universidad Autónoma de Madrid, Madrid, Spain.
Int J Oral Maxillofac Surg. 2020 Dec;49(12):1525-1534. doi: 10.1016/j.ijom.2020.03.009. Epub 2020 Apr 30.
Oral squamous cell carcinoma (OSCC) remains a challenge for head and neck surgeons, with low 5-year survival rates despite improvements in diagnostic techniques and therapies. This retrospective observational study was performed to evaluate the epidemiology and risk factors in a cohort of 666 patients with invasive OSCC over a 39-year period. Risk factors assessed were age, sex, toxic habits, premalignant lesions, tumour location and size, and neck involvement, and pathological factors such as surgical margins, tumour thickness, perineural invasion, and bone invasion. These factors were analysed over time, and their influence on recurrence and survival rates examined. Results were compared with those of current epidemiological studies in the literature. This series showed a tendency to diagnosis at older ages (P<0.001) and decreased differences in sex distribution (P<0.001) over time. Regarding risk factors, tobacco and alcohol drinking increased significantly in females, but remained stable in males. Forty percent of the patients developed recurrences during follow-up; the relapse rate did not improve over time (45.6% in the 1980s to 36.1% in 2010-2017). The 5-year survival rate also remained stable over time, ranging from 62.7% (1980s) to 71.7% (2010-2017). This epidemiological study analysed trends across four decades in a stable cohort, with results that may be extrapolated to the populations of European countries. The results confirmed that recurrence rates and survival rates have not improved over time, despite better surgical treatments and new therapies. Further studies are needed to improve knowledge about genetics and tumour behaviour in oral cancer.
口腔鳞状细胞癌（OSCC）仍然是头颈外科医生面临的一项挑战，尽管诊断技术和治疗方法有所改进，但5年生存率仍然较低。本回顾性观察研究旨在评估666例浸润性OSCC患者在39年期间的流行病学特征和危险因素。评估的危险因素包括年龄、性别、不良习惯、癌前病变、肿瘤位置和大小以及颈部受累情况，以及手术切缘、肿瘤厚度、神经侵犯和骨侵犯等病理因素。对这些因素随时间进行分析，并考察它们对复发率和生存率的影响。将结果与文献中当前的流行病学研究结果进行比较。该系列研究显示，随着时间的推移，诊断年龄有增大趋势（P<0.001），性别分布差异减小（P<0.001）。关于危险因素，女性吸烟和饮酒显著增加，而男性保持稳定。40%的患者在随访期间出现复发；复发率未随时间改善（20世纪80年代为45.6%，2010 - 2017年为36.1%）。5年生存率也随时间保持稳定，范围从62.7%（20世纪80年代）到71.7%（2010 - 2017年）。这项流行病学研究分析了一个稳定队列在40年中的趋势，其结果可能适用于欧洲国家人群。结果证实，尽管手术治疗和新疗法有所改进，但复发率和生存率并未随时间提高。需要进一步研究以增进对口腔癌遗传学和肿瘤行为的了解。
