Yamada Shin-Ichi, Kondo Eiji, Hashidume Masao, Sakurai Akinari, Otagiri Hiroki, Matsumura Naoki, Kubo Kiriko, Hakoyama Yusuke, Yajima Junichi, Morioka Masafumi, Akahane Yukiko, Anzai Kazunori, Goto Koichi, Uehara Takeshi, Sakai Hironori, Kurita Hiroshi
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
J Dent Sci. 2021 Jan;16(1):445-452. doi: 10.1016/j.jds.2020.09.012. Epub 2020 Oct 7.
Abstract.
BACKGROUND/PURPOSE: The clinical significance of minor risk factors remins uncertain in oral squamous cell carcinoma (OSCC) patients. The purpose of this study was to investigate the clinical impact of minor risk factors in OSCC patients.
The cases of OSCC patients that underwent surgery were retrospectively analyzed. Patients with major risk factors for recurrence, such as positive surgical margins or extracapsular spread, were excluded. The impact of possible minor risk factors on treatment outcomes was analyzed. One hundred and seventy-five patients with primary OSCC that underwent surgery were included in this study.
The 5-year overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) rates were 81.2%, 91.0%, and 72.4%, respectively. In multivariate analyses, RFS exhibited a significant association with the pattern of invasion (grade 4 vs. grades 1-3: hazard ratio: 3.096, 95% confidence interval: 1.367-6.884, p < 0.01), OS exhibited a tendency towards associations with the pattern of invasion and perineural invasion, and CSS displayed a tendency towards an association with perineural invasion. The prognosis of the patients with ≥2 minor risk factors was significantly worse than that of the patients with 0 or 1 minor risk factor(s) (OS: 91.6% vs. 64.5%, respectively, p < 0.01; CSS: 98.9% vs. 78.9%, respectively, p < 0.001; and RFS: 81.2% vs. 58.5%, respectively p < 0.05).
Grade 4 invasion and perineural invasion might be significant minor risk factors in OSCC patients. The presence of ≥2 minor risk factors might be a predictor of a poor prognosis in OSCC patients.
摘要。
背景/目的：在口腔鳞状细胞癌（OSCC）患者中，微小风险因素的临床意义仍不明确。本研究的目的是调查微小风险因素对OSCC患者的临床影响。
对接受手术的OSCC患者病例进行回顾性分析。排除具有复发主要风险因素的患者，如手术切缘阳性或包膜外扩散。分析可能的微小风险因素对治疗结果的影响。本研究纳入了175例接受手术的原发性OSCC患者。
5年总生存率（OS）、癌症特异性生存率（CSS）和无复发生存率（RFS）分别为81.2%、91.0%和72.4%。在多因素分析中，RFS与浸润模式显著相关（4级与1 - 3级：风险比：3.096，95%置信区间：1.367 - 6.884，p < 0.01），OS与浸润模式和神经周围浸润有相关趋势，CSS与神经周围浸润有相关趋势。具有≥2个微小风险因素的患者的预后明显差于具有0或1个微小风险因素的患者（OS：分别为91.6%和64.5%，p < 0.01；CSS：分别为98.9%和78.9%，p < 0.001；RFS：分别为81.2%和58.5%，p < 0.05）。
4级浸润和神经周围浸润可能是OSCC患者重要的微小风险因素。存在≥2个微小风险因素可能是OSCC患者预后不良的一个预测指标。
