Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Head and Neck Tumour Stream, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Int J Oral Maxillofac Surg. 2021 May;50(5):585-590. doi: 10.1016/j.ijom.2020.08.010. Epub 2020 Sep 8.
The contemporary literature is discordant regarding the role of delayed diagnosis in the prognosis of patients with oral cancer. This study examined data on a previously reported cohort of 101 patients with oral squamous cell carcinoma diagnosed at a single institution between 2008 and 2010. The time interval between symptom onset and initial histological diagnosis (diagnostic delay) was recorded for each patient, as were demographic data and cancer features such as T stage, nodal status, and smoking status. The mean follow-up period was 4 years 10 months. The mean diagnostic delay was 4 months, mean overall survival was 5years 6 months, and mean disease-specific survival was 4 years 9 months. No significant correlation was found between diagnostic delay and overall survival, disease-specific survival, or recurrence rates. Patients with node-positive disease were more likely to be diagnosed earlier, whereas women and non-smokers were more likely to have a delayed diagnosis. Inherent tumour biology is likely an important prognostic factor separate to diagnostic delay. Public education efforts should focus on symptom recognition and encourage early presentation for investigation of oral lesions, particularly for females and non-smokers, so that more aggressive tumours can be treated sooner to give the best chance at survival.
当代文献对于延迟诊断在口腔癌患者预后中的作用存在争议。本研究分析了在单一机构于 2008 年至 2010 年间诊断的 101 例口腔鳞状细胞癌患者的队列研究数据。记录每位患者从症状出现到首次组织学诊断（诊断延迟）的时间间隔，以及人口统计学数据和癌症特征，如 T 分期、淋巴结状态和吸烟状况。平均随访时间为 4 年 10 个月。平均诊断延迟为 4 个月，总生存率为 5 年 6 个月，疾病特异性生存率为 4 年 9 个月。诊断延迟与总生存率、疾病特异性生存率或复发率之间无显著相关性。淋巴结阳性疾病患者更有可能较早得到诊断，而女性和不吸烟者更有可能延迟诊断。肿瘤固有生物学可能是一个独立于诊断延迟的重要预后因素。公共教育应侧重于症状识别，并鼓励对口腔病变进行早期检查，尤其是对女性和不吸烟者，以便更早地治疗更具侵袭性的肿瘤，从而提高生存机会。
