Moore C, Flynn M B, Greenberg R A
Cancer. 1986 Jul 1;58(1):158-62. doi: 10.1002/1097-0142(19860701)58:1<158::aid-cncr2820580127>3.0.co;2-b.
Greatest surface diameter of a cancer, together with suspicion of regional node metastasis, forms the basis for prognosis through the clinical TNM staging system for many cancers. In oral cancer, however, surface size sometimes fails to correlate, or sometimes inversely correlates, with tumor aggressiveness. To shed light on the value of measuring size per se, 155 consecutive oral squamous cancers, treated by surgery, radiation, or a combination, were analyzed to find the degree of correlation between greatest surface measurement and pathologic nodal spread and control of cancer. In tumors less than 2 cm, size correlated with very few nodal metastases and with good prognoses; in tumors greater than 2 cm, increasing size did not show a corresponding increase in pathologic node metastasis or significantly worsening outcomes except for a few very large cancers invading adjacent structures. In conclusion, greatest surface diameter of an oral cancer, when greater than 2 cm, is an unreliable predictor of tumor behavior per se. A small pilot study suggests that tumor thickness may be a better predictor. A formal study of this is planned.
癌症的最大表面直径，连同区域淋巴结转移的怀疑，构成了许多癌症通过临床TNM分期系统进行预后评估的基础。然而，在口腔癌中，表面大小有时与肿瘤侵袭性不相关，有时甚至呈负相关。为了阐明测量大小本身的价值，对155例连续接受手术、放疗或联合治疗的口腔鳞状癌进行分析，以确定最大表面测量值与病理淋巴结转移及癌症控制之间的相关程度。在小于2厘米的肿瘤中，大小与极少的淋巴结转移及良好的预后相关；在大于2厘米的肿瘤中，除了少数侵犯相邻结构的非常大的癌症外，大小增加并未显示出病理淋巴结转移相应增加或结果显著恶化。总之，口腔癌的最大表面直径大于2厘米时，本身是肿瘤行为的不可靠预测指标。一项小型试点研究表明肿瘤厚度可能是更好的预测指标。对此计划进行正式研究。
