cT1N0M0 口腔鳞状细胞癌患者从选择性颈部清扫术获益：基于 SEER 的研究。

Patients With cT1N0M0 Oral Squamous Cell Carcinoma Benefit From Elective Neck Dissection: A SEER-Based Study.

机构信息

1Department of Oral and Maxillofacial Surgery and Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University.

2Department of Preventive Medicine, School of Public Health, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

J Natl Compr Canc Netw. 2021 Jan 29;19(4):385-392. doi: 10.6004/jnccn.2020.7632. Print 2021 Apr.

DOI:10.6004/jnccn.2020.7632

PMID:33378738

Abstract

BACKGROUND

The incidence of oral squamous cell carcinoma (OSCC) is increasing, with an estimated 369,000 new patients each year worldwide. Surgery is the primary treatment modality for early-stage OSCC, but there is scant evidence to prove the value of elective neck dissection (END) for relatively small early-stage OSCC. This study aimed to identify factors predicting survival for patients with clinical stage T1N0M0 (cT1N0M0) OSCC and whether up-front END improved survival.

PATIENTS AND METHODS

Patients with cT1N0M0 OSCC who underwent tumor resection with or without END were identified and extracted from the SEER database. Kaplan-Meier survival analysis was used to assess overall survival and disease-specific survival. Prognostic factors were determined using Cox regression analysis.

RESULTS

A total of 5,752 patients with cT1N0M0 OSCC were extracted, of whom 2,194 (38.1%) underwent tumor resection surgery with concurrent END and 3,558 (61.9%) underwent only tumor resection. In a multivariate Cox analysis, a relatively advanced age (>62 years) and relatively high pathologic grade were the significant negative predictors, but married status (hazard ratio, 0.709; P=.006) and undergoing END (hazard ratio, 0.708; P<.001) were identified as significant independent positive factors.

CONCLUSIONS

Patients with cT1N0M0 OSCC gain significant overall and disease-specific survival benefit from END.

摘要

背景

口腔鳞状细胞癌（OSCC）的发病率正在上升，全球每年估计有 36.9 万名新患者。手术是早期 OSCC 的主要治疗方式，但几乎没有证据证明选择性颈部清扫术（END）对相对较小的早期 OSCC 有价值。本研究旨在确定临床分期 T1N0M0（cT1N0M0）OSCC 患者的生存预测因素，以及 upfront END 是否能提高生存率。

患者和方法

从 SEER 数据库中确定并提取了接受肿瘤切除术联合或不联合 END 的 cT1N0M0 OSCC 患者。Kaplan-Meier 生存分析用于评估总生存率和疾病特异性生存率。使用 Cox 回归分析确定预后因素。

结果

共提取了 5752 例 cT1N0M0 OSCC 患者，其中 2194 例（38.1%）接受了肿瘤切除术联合同期 END，3558 例（61.9%）仅接受了肿瘤切除术。多变量 Cox 分析显示，相对较老的年龄（>62 岁）和相对较高的病理分级是显著的负预测因素，但已婚状态（风险比，0.709；P=.006）和接受 END（风险比，0.708；P<.001）是显著的独立正因素。