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90例上颌牙龈鳞状细胞癌重要预后因素的判定

Determination of Significant Prognostic Factors for Maxillary Gingival Squamous Cell Carcinoma in 90 Cases.

作者信息

Ohyama Yoshio, Yamashiro Masashi, Michi Yasuyuki, Uzawa Narikazu, Myo Kunihiro, Sonoda Itaru, Sumino Jun, Miura Chika, Mizutani Miho, Yamamoto Daisuke, Kayamori Kou, Yoda Tetsuya

机构信息

Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka 420-8690 Japan.

Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45Bunkyo-ku, Yushima, Tokyo 113-8510 Japan.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):5930-5935. doi: 10.1007/s12070-021-02559-z. Epub 2021 Apr 20.

Abstract

Maxillary gingival squamous cell carcinoma (MGSCC) occurs rather infrequently, compared to tongue and mandibular gingival carcinomas, among the cancers of the oral cavity. Therefore, significant numbers of MGSCC cases have not been statistically analysed. The aim of this study is to clarify the prognostic factors for MGSCC. We performed the statistical analysis of 90 MGSCC cases primarily treated in our department from 1999 to 2014. The patients (male: 36, female: 54) were aged between 38 and 93 years, and the mean age was 68.7 years. The number of patients in each tumour stage according to the TNM classification was as follows: T1: 15 cases, T2: 32 cases, T3: 13 cases, and T4: 30 cases. Forty-two patients were treated only by surgery, 5 only by radiotherapy, 3 by preoperative radiotherapy and surgery, and 40 patients were treated by combination therapy with preoperative chemoradiotherapy and surgery. Neck dissections were performed in 40 cases including 29 cases (11 primary and 18 secondary cases) of histopathologically diagnosed lymph node metastases. Extranodal extension was found in 74.3% cases with metastatic lymph nodes. The 5-year overall survival rate was 81.9%. In univariate analysis, the site of occurrence, stage of tumour, lymph node metastasis, and treatment contributed to the 5-year survival rate. Multivariate analysis demonstrated that the site of occurrence (posterior region) was an independent prognostic factor. Seventeen deaths occurred due to the primary disease, while three deaths were caused by other diseases. The posterior region cancers, according to the classification based on site of occurrence, were independent predictors of poor 5-year overall survival rate.

摘要

与舌癌和下颌牙龈癌相比,上颌牙龈鳞状细胞癌(MGSCC)在口腔癌中发病率较低。因此,尚未对大量MGSCC病例进行统计学分析。本研究的目的是阐明MGSCC的预后因素。我们对1999年至2014年在我科接受初次治疗的90例MGSCC病例进行了统计分析。患者(男性36例,女性54例)年龄在38至93岁之间,平均年龄为68.7岁。根据TNM分类,各肿瘤分期的患者数量如下:T1期:15例,T2期:32例,T3期:13例,T4期:30例。42例患者仅接受手术治疗,5例仅接受放射治疗,3例接受术前放疗和手术,40例患者接受术前放化疗和手术的联合治疗。40例行颈部清扫术,其中29例(11例为原发性,18例为继发性)经组织病理学诊断为淋巴结转移。74.3%的转移淋巴结病例发现有结外侵犯。5年总生存率为81.9%。单因素分析显示,发病部位、肿瘤分期、淋巴结转移和治疗对5年生存率有影响。多因素分析表明,发病部位(后部区域)是独立的预后因素。17例死于原发性疾病,3例死于其他疾病。根据发病部位分类,后部区域癌症是5年总生存率低的独立预测因素。

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