pT1-2 期口腔鳞状细胞癌伴单一同侧颈淋巴结转移（pN1）患者术后放疗和扩大颈部清扫术的获益。
The Benefit of Postoperative Radiotherapy and Extending Neck Dissection in pT1-2 Oral Squamous Cell Carcinoma With a Single Ipsilateral Cervical Lymph Node Metastasis (pN1).
机构信息
Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein (Campus Lübeck), Lübeck, Germany.
Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany.
出版信息
Anticancer Res. 2022 Jan;42(1):97-104. doi: 10.21873/anticanres.15462.
BACKGROUND/AIM: We compared postoperative radiotherapy (PORT) to surgery only (SO), and supraomohyoidal neck dissection (SOHND) to modified radical neck dissection (MRND) in patients with pT1-T2 squamous cell carcinomas of the oral cavity (OSCC) and a single cervical lymph node metastasis (pN1) in terms of overall survival (OS), oral cancer specific survival (OCSS), and regional recurrence-free survival (RRFS), in a prospective cohort study.
PATIENTS AND METHODS
We included patients with pT1-T2 pN1 OSCC with no distant metastasis and estimated the survival probabilities using the Kaplan-Meier method and calculated hazards ratios (HR) for PORT vs. SO and MRND vs. SOHND using adjusted Cox regression models.
RESULTS
A total of 51 patients (26 SO vs. 25 PORT, 9 SOHND vs. 42 MRND) were evaluated. Patients who received PORT were more likely to be younger and healthier. OS at 5 years was 41% and 87% in the SO and PORT groups, respectively. OS at 5 years was 52% and 67% in the in the SOHND and MRND groups, respectively. Both OCSS and RRFS were improved by PORT. Extending neck dissection was not associated with improved OS (HR = 0.83).
CONCLUSION
PORT is associated with preferable OS, OCSS, and RRFS in pT1-2 pN1 oral cancer and should be recommended regularly.
背景/目的：我们在一项前瞻性队列研究中，比较了术后放疗（PORT）与单纯手术（SO），以及经口腔入路颏下颈清扫术（SOHND）与改良根治性颈清扫术（MRND）在口腔鳞癌（OSCC）pT1-T2 且仅有单一颈部淋巴结转移（pN1）患者中的总体生存率（OS）、口腔癌特异性生存率（OCSS）和区域无复发生存率（RRFS）。
患者和方法
我们纳入了无远处转移且预计生存概率的 pT1-T2 pN1 OSCC 患者，使用 Kaplan-Meier 法计算生存概率，并使用调整后的 Cox 回归模型计算 PORT 与 SO 以及 MRND 与 SOHND 的风险比（HR）。
结果
共评估了 51 例患者（26 例 SO 与 25 例 PORT，9 例 SOHND 与 42 例 MRND）。接受 PORT 的患者更年轻、更健康。SO 组和 PORT 组的 5 年 OS 分别为 41%和 87%。SOHND 组和 MRND 组的 5 年 OS 分别为 52%和 67%。PORT 还改善了 OCSS 和 RRFS。扩大颈部清扫术与 OS 改善无关（HR=0.83）。
结论
PORT 与 pT1-2 pN1 口腔癌患者的 OS、OCSS 和 RRFS 改善相关，应常规推荐。
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