在加利西亚（西班牙）的一家医院诊断和治疗的口腔鳞状细胞癌的流行病学、临床和预后分析：一项具有 5 年随访的回顾性研究。
Epidemiological, clinical, and prognostic analysis of oral squamous cell carcinoma diagnosed and treated in a single hospital in Galicia (Spain): a retrospective study with 5-year follow-up.
机构信息
Department of Stomatology II University of the Basque Country (UPV/EHU) Barrio Sarriena s/n, 48940, Leioa, Spain
出版信息
Med Oral Patol Oral Cir Bucal. 2024 Jan 1;29(1):e36-e43. doi: 10.4317/medoral.26047.
BACKGROUND
Oral cancer is a common neoplasm worldwide, mostly corresponding to squamous cell carcinoma (OSCC). Unfortunately, its overall prognosis remains poor, with no improvement in recent decades. In this study, we have analysed the epidemiological, clinical, and prognostic characteristics of OSCC on patients of a specific Spanish region (Galicia), in order to improve its prognosis and apply effective preventive and early diagnosis measures.
MATERIAL AND METHODS
We retrospectively analysed 243 cases of OSCC, diagnosed and treated in a single hospital centre in Galicia between 2010 and 2015 (minimum of 5 years of evolution). Overall and specific survival were calculated (Kaplan-Meier) and associated variables were identified (log rank test and Cox regression).
RESULTS
The mean age of the patients was 67 years, with the majority being male (69.5%), smokers (45.9%) and alcohol consumers (58.6%), who lived in non-urban areas (79.4%). Cases diagnosed at advanced stages entailed the 48.1% of the sample, and 38.7% of cases relapsed. The 5-year overall and disease-specific survival rates were 39.9% and 46.1%, respectively. Patients who consumed tobacco and alcohol had a worse prognosis. OSCC cases referred to hospital by specialist dentists had a better prognosis, as those who were previously diagnosed with an oral potentially malignant oral disorder (OPMD) or received dental care during OSCC treatment.
CONCLUSIONS
In view of these findings, we conclude that OSCC in Galicia (Spain) still has a very poor overall prognosis, which is mainly related to the advanced age of the patients and the late diagnosis. Our study highlights the better survival of OSCC in relation to the referring health professional, the presence of a previous OPMD and the dental care after diagnosis. This demonstrates the importance of dentistry as a health profession involved in the early diagnosis and multidisciplinary management of this malignant neoplasm.
背景
口腔癌是一种常见的全球肿瘤，主要对应鳞状细胞癌（OSCC）。不幸的是，其整体预后仍然较差，近几十年来没有改善。在这项研究中，我们分析了特定西班牙地区（加利西亚）患者的 OSCC 的流行病学、临床和预后特征，以改善其预后并应用有效的预防和早期诊断措施。
材料和方法
我们回顾性分析了 2010 年至 2015 年期间在加利西亚的一家医院中心诊断和治疗的 243 例 OSCC 患者（至少 5 年的病程）。计算总生存率和特定生存率（Kaplan-Meier）并确定相关变量（对数秩检验和 Cox 回归）。
结果
患者的平均年龄为 67 岁，大多数为男性（69.5%）、吸烟者（45.9%）和饮酒者（58.6%），居住在非城市地区（79.4%）。诊断为晚期的病例占样本的 48.1%，38.7%的病例复发。5 年总生存率和疾病特异性生存率分别为 39.9%和 46.1%。吸烟和饮酒的患者预后较差。由专科牙医转诊的 OSCC 患者预后较好，因为那些以前被诊断为口腔潜在恶性疾病（OPMD）或在 OSCC 治疗期间接受过牙科护理的患者。
结论
鉴于这些发现，我们得出结论，加利西亚（西班牙）的 OSCC 总体预后仍然非常差，这主要与患者的高龄和晚期诊断有关。我们的研究强调了与转诊的卫生专业人员、先前存在的 OPMD 和诊断后接受的牙科护理相关的 OSCC 更好的生存率。这表明了牙科作为涉及这种恶性肿瘤的早期诊断和多学科管理的卫生专业的重要性。
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