Maxillofacial Unit, University-Hospital of Parma, Parma, Italy.
Maxillofacial Unit, University-Hospital of Verona, Verona, Italy.
J Oral Pathol Med. 2023 Sep;52(8):746-750. doi: 10.1111/jop.13469. Epub 2023 Aug 1.
Oral squamous cell carcinoma (OSCC) treatment is based largely on the TNM stage. The eighth edition includes important new prognostic parameters (extranodal extension and depth of invasion), while it does not consider tumour molecular characteristics or minor invasion criteria (perineural and lymphovascular invasion, grading and resection margins). This study evaluated how well the TNM eighth edition predicts the biological behaviour of OSCC, considering survival and risk of locoregional recurrence.
Data from 217 patients treated for OSCC were analysed, including epidemiologic characteristics, histological features and treatment.
No significant correlations with overall survival or tumour recurrence were found for pT stages and the type of treatment, while different pN stages had significant differences in recurrence, but not in overall survival. We found significant correlations between overall survival and tumour grade and lymphovascular and perineural invasion and a significant correlation between tumour resection margins and the risk of recurrence.
The current TNM staging system is a necessary but not sufficient tool for predicting the overall survival and risk of recurrence of OSCC. It could be improved by considering other factors, such as minor invasion criteria and biological markers.
口腔鳞状细胞癌（OSCC）的治疗主要基于 TNM 分期。第八版包括重要的新预后参数（淋巴结外侵犯和浸润深度），但不考虑肿瘤分子特征或微小侵犯标准（神经周围和血管侵犯、分级和切缘）。本研究评估了第八版 TNM 分期在考虑生存和局部区域复发风险时，对 OSCC 生物学行为的预测能力。
分析了 217 例接受 OSCC 治疗的患者的数据，包括流行病学特征、组织学特征和治疗情况。
pT 分期和治疗类型与总生存率或肿瘤复发无显著相关性，而不同的 pN 分期在复发方面有显著差异，但在总生存率方面无差异。我们发现总生存率与肿瘤分级、血管侵犯和神经周围侵犯显著相关，肿瘤切缘与复发风险显著相关。
目前的 TNM 分期系统是预测 OSCC 总生存率和复发风险的必要但不充分的工具。通过考虑其他因素，如微小侵犯标准和生物标志物，可以对其进行改进。
