Newman M, Dziegielewski P T, Nguyen N T A, Seikaly H S, Xie M, O'Connell D A, Harris J R, Biron V L, Gupta M K, Archibald S D, Jackson B S, Young J E M, Keyes K J, Nichols D S, Zhang H
Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainsville, FL, United States.
Oral Oncol. 2021 May;116:105195. doi: 10.1016/j.oraloncology.2021.105195. Epub 2021 Feb 19.
Current research is elucidating how the addition of depth of invasion (DOI) to the 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging for oral cavity squamous cell carcinoma influences its prognostic accuracy. However, there is limited research on survival in pT3N0M0 oral tongue SCC (OTSCC) patients when stratifying by DOI.
Determine 5-year overall survival (OS), and cancer-specific survival (CSS) for patients with pT3N0M0 oral OTSCC based on shallow DOI (<10 mm) and deep DOI (10-20 mm).
Retrospective review involving three tertiary care cancer centers in North America. cT3N0M0 OTSCC patients receiving primary surgical treatment from 2004 to 2018 were identified. Inclusion: age > 18 years old and confirmation of pT3N0M0 OTSCC on surgical pathology. Exclusion: patients undergoing palliative treatment or previous head and neck surgery/radiotherapy. Analysis comprised two groups: shallow pT3 (tumor diameter > 4 cm, DOI < 10 mm) and deep pT3 (DOI 10 mm-20 mm).
One hundred and four patients with pT3N0M0 OTSCC were included. Mean age was 59.1 years (range: 18-80.74). Age, gender, and Charlson Comorbidity Index were similar between the two groups (p > 0.05). Recurrence, LVI, PNI, and positive margins were more common in deep T3 tumors (P < 0.05). 5-year OS (50% vs 26%, p = 0.006) and CSS (72% vs 24%, p = 0.005) were worse in deep pT3 tumors. Deep pT3 disease was an independent predictor of OS (p = 0.004) and CSS (p = 0.01) on Cox-Regression analysis.
DOI is an independent predictor of poor survival in pT3N0M0 OTSCC patients. Consideration should be given to escalating adjuvant therapy for deep pT3N0M0 OTSCC patients.
当前研究正在阐明，将浸润深度（DOI）纳入美国癌症联合委员会（AJCC）第8版口腔鳞状细胞癌TNM分期如何影响其预后准确性。然而，关于pT3N0M0口腔舌鳞状细胞癌（OTSCC）患者按DOI分层后的生存率研究有限。
确定基于浅DOI（<10毫米）和深DOI（10 - 20毫米）的pT3N0M0口腔OTSCC患者的5年总生存率（OS）和癌症特异性生存率（CSS）。
对北美三个三级医疗癌症中心进行回顾性研究。确定2004年至2018年接受原发性手术治疗的cT3N0M0 OTSCC患者。纳入标准：年龄>18岁且手术病理证实为pT3N0M0 OTSCC。排除标准：接受姑息治疗或既往有头颈部手术/放疗史的患者。分析分为两组：浅pT3（肿瘤直径>4厘米，DOI<10毫米）和深pT3（DOI 10毫米 - 20毫米）。
纳入104例pT3N0M0 OTSCC患者。平均年龄为59.1岁（范围：18 - 80.74）。两组之间的年龄、性别和查尔森合并症指数相似（p>0.05）。复发、淋巴管浸润（LVI）、神经周围浸润（PNI）和切缘阳性在深T3肿瘤中更常见（P<0.05）。深pT3肿瘤的5年OS（50%对26%，p = 0.006）和CSS（72%对24%，p = 0.005）更差。在Cox回归分析中，深pT3疾病是OS（p = 0.004）和CSS（p = 0.01）的独立预测因素。
DOI是pT3N0M0 OTSCC患者生存不良的独立预测因素。对于深pT3N0M0 OTSCC患者，应考虑加强辅助治疗。
