HPV 阳性口咽癌的手术切缘状态和辅助治疗作用。
Surgical margin status and role of adjuvant therapy in human papillomavirus-positive oropharyngeal cancer.
机构信息
Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.
出版信息
Head Neck. 2023 Sep;45(9):2369-2376. doi: 10.1002/hed.27473. Epub 2023 Jul 24.
BACKGROUND
We analyzed the difference in treatment results according to safety margin range and studied the role of adjuvant therapy in patients with human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC).
MATERIALS AND METHODS
A total of 279 patients with HPV+ OPSCC were included in this study.
RESULTS
Surgical margin and T classification were significant prognostic factors related to death. The difference in locoregional recurrence was analyzed by dividing the safety margin into groups of <1, 1-5, and >5 mm. There was no significant difference in local-regional recurrence for T1-T2 lesions between the three groups. Adjuvant therapy can significantly reduce disease recurrence in HPV+ OPSCC patients with risk factors.
CONCLUSIONS
In T1-T2 lesions without other risk factors, even with a safety margin ≥1 mm, adjuvant therapy can potentially be omitted. Adjuvant therapy can significantly reduce disease recurrence in HPV+ OPSCC patients with risk factors.
背景
我们分析了根据安全边缘范围的治疗结果差异，并研究了辅助治疗在 HPV 阳性（HPV+）口咽鳞状细胞癌（OPSCC）患者中的作用。
材料和方法
本研究共纳入 279 例 HPV+ OPSCC 患者。
结果
手术切缘和 T 分类是与死亡相关的显著预后因素。通过将安全边缘分为<1、1-5 和>5mm 组来分析局部区域复发的差异。在三组中，T1-T2 病变的局部区域复发无显著差异。对于有危险因素的 HPV+ OPSCC 患者，辅助治疗可显著降低疾病复发率。
结论
在没有其他危险因素的 T1-T2 病变中，即使安全边缘≥1mm，也可能不需要辅助治疗。辅助治疗可显著降低 HPV+ OPSCC 患者的疾病复发率。
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