T4a期及切迹下T4b期口腔癌手术疗效的Meta分析

A Meta-analysis of Surgical Outcomes of T4a and Infranotch T4b Oral Cancers.

作者信息

Rao Karthik Nagaraja, Arora Ripudaman, Dange Prajwal, Nagarkar Nitin, Mäkitie Antti A, Kowalski Luiz P, Eisbruch Avraham, Hamoir Marc, Civantos Francisco J, Vander Poorten Vincent, Ng Sweet Ping, Nuyts Sandra, Zafereo Mark, Asarkar Ameya A, Golusinski Paweł, Ronen Ohad, Ferlito Alfio

机构信息

Department of Head and Neck Surgical Oncology, All India Institute of Medical Sciences, Raipur, India.

Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India.

出版信息

Oncol Ther. 2023 Dec;11(4):461-480. doi: 10.1007/s40487-023-00246-3. Epub 2023 Oct 7.

DOI:10.1007/s40487-023-00246-3

PMID:37804420

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10673764/

Abstract

OBJECTIVE

To determine the overall surgical outcomes of infranotch T4b oral cancers and compare them with T4a oral cancers.

METHODS

PubMed, EMBASE and Cochrane databases from 2000 to 2022 were systematically searched. Clinical studies reporting at least one outcome following curative surgery and adjuvant therapy for comparison of patients with either infranotch T4b (IN-T4b) or T4a tumour. The heterogeneity of the included studies was determined using Tau-squared, Chi-squared, and the Higgins I test. The random effects model was used to determine the log odds ratio (logOR).

RESULTS

The systematic review comprised 11,790 patients from 16 included studies. Seven studies were included in the meta-analysis (n = 11,381). For IN-T4b patients, the pooled 2 and 5 year overall survival (OS) were 59.3% and 53.2%, 2 and 5 year disease-free survival (DFS) 57.9% and 48.4%, 2 and 5 year disease-specific survival (DSS) 72% and 68%, and 2 and 5 year local control (LC), 47% and 56%, respectively. There was no statistically significant difference in 2 year OS [logOR = 0.28 (-0.47, 1.03), p = 0.46, confidence interval (CI) = 95%], 5 year OS [logOR = 0.7 (-0.4, 1.8), p = 0.54, CI = 95%], 2 year DFS [logOR = 0.22 (-0.35, 0.79), p = 0.45, CI = 95%], 5 year DFS [logOR = 0.17 (-0.42, 0.77), p = 0.57, CI = 95%], 2 year LC [logOR = 0.47 (-0.33, 1.26), p = 0.25, CI = 95%] and 5 year LC [logOR = 0.34 (-0.31, 0.99), p = 0.31, CI = 95%] between IN-T4b and T4a oral cancers.

CONCLUSION

Results of this meta-analysis suggest that IN-T4b oral cancers have similar outcomes to T4a oral cancers, which supports down-staging IN-T4b cancers to T4a cancers.

摘要

目的

确定切迹下T4b期口腔癌的总体手术疗效，并与T4a期口腔癌进行比较。

方法

系统检索2000年至2022年的PubMed、EMBASE和Cochrane数据库。纳入报告了针对切迹下T4b（IN-T4b）或T4a肿瘤患者进行根治性手术及辅助治疗后至少一项疗效的临床研究。采用Tau平方、卡方和希金斯I检验来确定纳入研究的异质性。使用随机效应模型确定对数比值比（logOR）。

结果

该系统评价纳入了16项研究中的11790例患者。荟萃分析纳入了7项研究（n = 11381）。对于IN-T4b患者，汇总的2年和5年总生存率（OS）分别为59.3%和53.2%，2年和5年无病生存率（DFS）分别为57.9%和48.4%，2年和5年疾病特异性生存率（DSS）分别为72%和68%，2年和5年局部控制率（LC）分别为47%和56%。IN-T4b期和T4a期口腔癌在2年OS[logOR = 0.28（-0.47，1.03），p = 0.46，置信区间（CI）= 95%]、5年OS[logOR = 0.7（-0.4，1.8），p = 0.54，CI = 95%]、2年DFS[logOR = 0.22（-0.35，0.79），p = 0.45，CI = 95%]、5年DFS[logOR = 0.17（-0.42，0.77），p = 0.57，CI = 95%]、2年LC[logOR = 0.47（-0.33，1.26），p = 0.25，CI = 95%]和5年LC[logOR = 0.34（-0.