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切除边缘不典型增生对口腔舌鳞癌根治性切除后肿瘤学结果的影响:高级别不典型增生切除边缘的意义。

Impact of dysplasia at resection margin on oncologic outcome after curative resection of oral tongue squamous cell carcinoma: significance of high-grade dysplastic resection margin.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.

Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

出版信息

Eur Arch Otorhinolaryngol. 2024 Jan;281(1):441-449. doi: 10.1007/s00405-023-08233-0. Epub 2023 Oct 4.

Abstract

BACKGROUND

This study aimed to compare the oncologic outcomes among negative, close, positive, and dysplasia resection margins (RMs) with oral tongue squamous cell carcinoma (OSCC) and to investigate the impact of dysplastic RMs.

METHODS

The 565 patients were retrospectively analyzed and divided into four groups according to RM. Dysplasia was classified into mild, moderate, and severe subgroups.

RESULTS

RMs consisted of negative (62.1%), close (27.1%), positive (2.1%), and dysplastic (8.7%). In multivariate analysis, advanced T/N stages and positive RM were significant risk factors for overall survival, while dysplasia at the RM was not a significant risk factor for locoregional recurrence or overall survival. In subgroup analysis of patients with dysplastic margin, RM with severe dysplasia showed higher recurrence than mild and moderate dysplasia.

CONCLUSIONS

Dysplastic RM was not a risk factor for recurrence and survival. Severe dysplasia RM should be carefully observed due to higher recurrence compared to other dysplasia RMs.

摘要

背景

本研究旨在比较口腔舌鳞癌(OSCC)的阴性、接近、阳性和异型切除边缘(RMs)的肿瘤学结果,并探讨异型 RMs 的影响。

方法

回顾性分析了 565 例患者,并根据 RM 将其分为四组。将异型性分为轻度、中度和重度亚组。

结果

RMs 包括阴性(62.1%)、接近(27.1%)、阳性(2.1%)和异型(8.7%)。多因素分析显示,晚期 T/N 分期和阳性 RM 是总生存的显著危险因素,而 RM 异型性不是局部区域复发或总生存的显著危险因素。在有异型性边缘的患者亚组分析中,重度异型性 RM 的复发率高于轻度和中度异型性。

结论

异型性 RM 不是复发和生存的危险因素。由于与其他异型性 RMs 相比,重度异型性 RM 的复发率更高,因此应仔细观察。

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