软组织中无复发性二级肿瘤切缘对 R0 切除的口腔鳞状细胞癌局部、区域和远处复发的影响。
Impact of secondary tumor-free resection margins in soft tissue on local, regional, and distant recurrence in R0-resected oral squamous cell carcinoma.
机构信息
Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
出版信息
Head Neck. 2022 May;44(5):1172-1181. doi: 10.1002/hed.27014. Epub 2022 Feb 21.
BACKGROUND
The impact of additional soft tissue resection on recurrence of oral squamous cell carcinoma (OSCC) remains controversial. The study aim was to compare recurrence between patients with secondary tumor-free resection margins after intraoperative additional resection (STF-RM) and patients with primary tumor-free resection margins without additional resection (PTF-RM).
METHODS
Forty-five patients with STF-RM were matched with patients with PTF-RM according to Union for International Cancer Control stage, tumor location, and treatment modality and compared for local, regional, and distant recurrence.
RESULTS
Patients with STF-RM showed lower local and distant control rates compared to patients with PTF-RM (66.2% vs. 82.8%; p = 0.045 and 86.3% vs. 100.0%; p = 0.021). STF-RM was the only predictor of local recurrence accounting for tumor (T) status, nodal (N) status, tumor grade, margin distance, and extracapsular extension (hazard ratio 4.21 [95% confidence interval 1.26-14.04]; p = 0.019).
CONCLUSIONS
STF-RM have an adverse impact on local and distant recurrence of OSCC.
背景
术中额外切除后获得的无肿瘤切缘（STF-RM）对口腔鳞状细胞癌（OSCC）复发的影响仍存在争议。本研究旨在比较接受术中额外切除的患者（STF-RM）与未接受额外切除的患者（PTF-RM）的无肿瘤切缘复发率。
方法
根据国际抗癌联盟分期、肿瘤位置和治疗方式，将 45 例 STF-RM 患者与 PTF-RM 患者进行匹配，并比较局部、区域和远处复发情况。
结果
与 PTF-RM 患者相比，STF-RM 患者的局部和远处控制率较低（66.2% vs. 82.8%；p=0.045 和 86.3% vs. 100.0%；p=0.021）。STF-RM 是局部复发的唯一预测因素，可预测肿瘤（T）分期、淋巴结（N）分期、肿瘤分级、切缘距离和囊外扩展（风险比 4.21 [95%置信区间 1.26-14.04]；p=0.019）。
结论
STF-RM 对 OSCC 的局部和远处复发有不利影响。
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