口腔多发性原发性癌与口腔单发性原发性癌的临床特征比较。
Clinical Features of Oral Multiple Primary Carcinomas Compared with Oral Single Primary Carcinoma.
作者信息
Kawasaki Makoto, Tamura Takayuki, Harada Yusei, Fujii Nobuyuki, Doi Rieko, Kodani Isamu
机构信息
Division of Oral Maxillofacial Surgery, Department of Sensory and Motor of Organs, School of Medicine, Factory of Medicine, Tottori University, Yonago 683-8503, Japan.
出版信息
Yonago Acta Med. 2020 Sep 14;63(4):246-254. doi: 10.33160/yam.2020.11.002. eCollection 2020 Nov.
BACKGROUND
Owing to the increase in the older population and the increased life span, the number of patients with oral multiple primary carcinomas will increase. Predicting the second and third carcinoma clinically is difficult, and the presence of second or third carcinomas is a factor that determines the prognosis of oral carcinoma. In this study, we examined the clinical features of oral multiple primary carcinomas treated in our department.
METHODS
We retrospectively reviewed the medical records of patients with oral squamous cell carcinoma who underwent radical treatment at and were followed by the Department of Oral and Maxillofacial Surgery, Tottori University Hospital from January 2003 to October 2017.
RESULTS
This study included 261 patients: 241 patients had oral single primary carcinoma and 20 patients had oral multiple primary carcinomas. Oral multiple primary carcinomas showed female predilection and occurred more frequently in the lower gingiva and significantly less frequently in the tongue ( < 0.01). Oral multiple primary carcinomas showed a significantly higher recurrence rate ( < 0.01). The 5-year overall survival of oral single primary carcinoma patients was 88.0% compared with 95% for oral multiple primary carcinomas, with no significant difference (log rank test, = 0.54). However, the 15-year survival rate dropped to 28.1% in oral multiple primary carcinomas. The cumulative disease incidence rates of metachronous second primary carcinoma from first carcinoma at 5 years and 10 years were 3.45% and 5.36%, respectively.
CONCLUSION
Oral multiple primary carcinomas rarely occur in the tongue. The 5-year survival rate showed no difference between single and multiple carcinoma patients, but over longer observation, the prognosis of multiple carcinoma was poor owing to a high recurrence rate. Because of the high recurrence rate and risk of further metachronous carcinoma in oral multiple primary carcinomas, longer-term follow-up is required.
背景
由于老年人口的增加和寿命的延长，口腔多发性原发性癌患者的数量将会增加。临床上预测第二和第三原发性癌很困难，而第二或第三原发性癌的存在是决定口腔癌预后的一个因素。在本研究中，我们调查了在我科接受治疗的口腔多发性原发性癌的临床特征。
方法
我们回顾性分析了2003年1月至2017年10月在鸟取大学医院口腔颌面外科接受根治性治疗并随访的口腔鳞状细胞癌患者的病历。
结果
本研究纳入261例患者：241例患有口腔单发性原发性癌，20例患有口腔多发性原发性癌。口腔多发性原发性癌表现出女性偏好，在下牙龈更常见，而在舌部显著少见（<0.01）。口腔多发性原发性癌的复发率显著更高（<0.01）。口腔单发性原发性癌患者的5年总生存率为88.0%，而口腔多发性原发性癌患者为95%，无显著差异（对数秩检验，=0.54）。然而，口腔多发性原发性癌的15年生存率降至28.1%。第一原发性癌发生异时性第二原发性癌的5年和10年累积疾病发病率分别为3.45%和5.36%。
结论
口腔多发性原发性癌很少发生在舌部。单发性和多发性癌患者的5年生存率无差异，但随着观察时间延长，由于复发率高，多发性癌的预后较差。由于口腔多发性原发性癌的高复发率和进一步发生异时性癌的风险，需要进行长期随访。
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