Universidade Federal do Rio Grande do Sul - UFRGS, Department of Oral Pathology and Oral Medicine, Porto Alegre, RS, Brazil.
Complexo Hospitalar Santa Casa, Hospital Santa Rita, Department of Head and Neck Surgery, Porto Alegre, RS, Brazil.
Braz Oral Res. 2022 May 2;36:e058. doi: 10.1590/1807-3107bor-2022.vol36.0058. eCollection 2022.
The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.
本研究旨在评估硬腭、上牙龈和牙槽嵴（HPUGAR）口腔鳞状细胞癌（OSCC）患者的临床病理特征和治疗方案作为预后因素。本回顾性队列研究收集了 1999 年至 2021 年间在巴西南部两个头颈外科部门治疗的患者数据。收集了临床病理数据、习惯、部位、大小、临床特征、临床分期、颈部转移、治疗和生存信息。使用 Pearson 卡方检验和二项回归评估独立变量与结局之间的关联。采用 Kaplan-Meier 检验比较不同颈部入路的生存情况。共纳入 41 例患者，其中男性占 61%，平均年龄为 68.8（±13.9）岁。男性患者中，吸烟（p=0.003）和饮酒（p=0.02）的比例明显高于女性患者。研究样本中主要的临床特征是病变大于 2cm（48.7%）、无颈部（90.2%）或远处转移（90.2%）。单独手术是主要的治疗方法（48.8%）。34 例（83.0%）采用观察等待策略，5 例（12.2%）采用选择性颈部清扫术。仅有 2 例 cN0 疾病（4.9%）患者在随访时出现颈部转移。8 例（12.2%）患者死于疾病。临床病理变量、习惯、手术切缘和组织学亚型与颈部转移或生存无显著相关性。颈部转移（p=0.004）与预后不良相关。不同颈部入路的生存无差异（p=0.28）。颈部转移和局部复发是 HPUGAR OSCC 的负性预后因素。
