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口腔鳞状细胞癌患者接受完全手术切除作为主要治疗后的监测:一项单中心回顾性队列研究

Surveillance for Patients with Oral Squamous Cell Carcinoma after Complete Surgical Resection as Primary Treatment: A Single-Center Retrospective Cohort Study.

作者信息

Fukumoto Chonji, Oshima Ryo, Sawatani Yuta, Shiraishi Ryo, Hyodo Toshiki, Kamimura Ryouta, Hasegawa Tomonori, Komiyama Yuske, Izumi Sayaka, Fujita Atsushi, Wakui Takahiro, Kawamata Hitoshi

机构信息

Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine, Mibu 321-0293, Tochigi, Japan.

Department of Oral and Maxillofacial Surgery, Kamma Memorial Hospital, Nasushiobara 325-0046, Tochigi, Japan.

出版信息

Cancers (Basel). 2021 Nov 21;13(22):5843. doi: 10.3390/cancers13225843.

Abstract

BACKGROUND

The surveillance methods oral squamous cell carcinoma (OSCC) patients may be chosen by considering the risk for recurrence, and it is important to establish appropriate methods during the period in which latent/dormant cancer cells become more apparent. To investigate the appropriate surveillance of patients with OSCC based on the individual risk for recurrence and/or metastasis, we performed a retrospective cohort study after the complete surgical resection of OSCC as the primary treatment.

METHODS

The study was performed in 324 patients with OSCC who had been primarily treated with surgery from 2007 to 2020 at our hospital. We investigated the period, timing, and methods (visual examination, palpation and imaging using FDG-PET/CT or CECT) for surveillance in each case that comprised postsurgical treatment.

RESULTS

Regarding the time to occurrence of postsurgical events, we found that half of cases of local recurrence, cervical lymph node metastasis, and distant metastasis occurred within 200 days, and 75% of all of these events occurred within 400 days. However, the mean time for second primary cancer was 1589 days. The postsurgical events were detected earlier by imaging examinations than they were by visual examination and palpation.

CONCLUSIONS

For the surveillance of patients with OSCC after primary surgery, it is desirable to perform FDG-PET/CT within 3-6 months and at 1 year after surgery and to consider CECT as an option in between FDG-PET/CT, while continuing history and physical examinations for about 5 years based on individual risk assessment.

摘要

背景

口腔鳞状细胞癌(OSCC)患者的监测方法可根据复发风险来选择,在潜伏/休眠癌细胞变得更加明显的时期建立合适的方法很重要。为了基于个体复发和/或转移风险研究OSCC患者的适当监测方法,我们在OSCC作为主要治疗手段进行完全手术切除后开展了一项回顾性队列研究。

方法

该研究纳入了2007年至2020年在我院接受手术作为主要治疗的324例OSCC患者。我们调查了每例患者术后治疗中监测的时间、时机和方法(视觉检查、触诊以及使用FDG-PET/CT或CECT进行成像)。

结果

关于术后事件发生的时间,我们发现局部复发、颈部淋巴结转移和远处转移病例的一半在200天内发生,所有这些事件的75%在400天内发生。然而,第二原发性癌症的平均时间为1589天。成像检查比视觉检查和触诊更早发现术后事件。

结论

对于OSCC患者初次手术后的监测,理想的做法是在术后3至6个月以及1年时进行FDG-PET/CT检查,并在FDG-PET/CT检查之间考虑将CECT作为一种选择,同时根据个体风险评估持续进行约5年的病史和体格检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71f4/8616227/960e095bc2fd/cancers-13-05843-g001.jpg

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