Department of Oral & Maxillofacial Surgery, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases Shanghai Stomatological Hospital,, Fudan University, 356 Beijing East Road, Shanghai, 200001, PR China.
Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, 356 Beijing East Road, Shanghai, 200001, PR China.
BMC Cancer. 2021 Dec 7;21(1):1309. doi: 10.1186/s12885-021-09053-3.
Treatment of clinical N0 neck tumours is controversial in early-stage oral squamous cell carcinoma (OSCC), possibly because T1N0M0 and T2N0M0 merge together at early stages. The purposes of this study were to compare survival outcomes only for T2N0M0 cases based upon treatment elective neck dissection versus neck observation.
T2N0M0 OSCC cases were identified in the Surveillance, Epidemiology, and End Results database of the United States National Cancer Institute between 2004 and 2015. Survival curves for different variable values were generated using Kaplan-Meier estimates and compared using the log-rank test. Variables that achieved significance at P < 0.05 were entered into multivariable analyses via the Cox proportional hazards multivariate regression.
A total of 2857 patients were selected, and 2313 cases were available for disease specific survival (DSS). The 5-year and 10-year overall survival (OS) were 66.7 and 46% for patients receiving elective neck dissection (END), respectively, and 56.4 and 37.2% for patients with neck observation (P < 0.0001). The 5-year and 10-year DSS were 73.6 and 64% for the END group, respectively, versus 64.5 and 54.5% for the neck observation group (P < 0.0001). More importantly, performing END was independently associated with favourable DSS and OS for patients with T2N0M0 OSCC [hazard ratio (HR) = 0.769, P = 0.0069 for DSS; HR = 0.829, P = 0.0031 for OS, neck observation group as reference] according to multivariate survival analysis.
END is recommended for T2N0M0 OSCC cases and it is associated with improved DSS and OS.
在早期口腔鳞状细胞癌（OSCC）中，对临床 N0 颈部肿瘤的治疗存在争议，这可能是因为 T1N0M0 和 T2N0M0 在早期阶段合并在一起。本研究的目的是仅比较 T2N0M0 病例基于选择性颈部清扫术与颈部观察的生存结果。
在美国国立癌症研究所的监测、流行病学和最终结果数据库中，确定了 2004 年至 2015 年间 T2N0M0 OSCC 病例。使用 Kaplan-Meier 估计生成不同变量值的生存曲线，并使用对数秩检验进行比较。在 P < 0.05 时具有统计学意义的变量通过 Cox 比例风险多变量回归进入多变量分析。
共选择了 2857 例患者，其中 2313 例可用于疾病特异性生存（DSS）。接受选择性颈部清扫术（END）的患者的 5 年和 10 年总生存率（OS）分别为 66.7%和 46%，而颈部观察的患者分别为 56.4%和 37.2%（P < 0.0001）。END 组的 5 年和 10 年 DSS 分别为 73.6%和 64%，而颈部观察组分别为 64.5%和 54.5%（P < 0.0001）。更重要的是，根据多变量生存分析，对于 T2N0M0 OSCC 患者，进行 END 与有利的 DSS 和 OS 相关（危险比[HR] = 0.769，P = 0.0069 用于 DSS；HR = 0.829，P = 0.0031 用于 OS，以颈部观察组为参考）。
建议对 T2N0M0 OSCC 病例进行 END，它与改善的 DSS 和 OS 相关。
