Riju Jeyashanth, Tirkey Amit Jiwan, Vidya Konduru, Agarwal Mansi, Babu Malavika, Kurian Reshma, Paulose Antony
Department of Head and Neck Surgery, Christian Medical College, Vellore, India.
Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, CF14 4YS UK.
Indian J Surg Oncol. 2023 Sep;14(3):733-741. doi: 10.1007/s13193-023-01750-8. Epub 2023 Apr 27.
In India, oral cancers are the major cause of cancer-related death. Tongue and buccal mucosa being the major subsites in oral cancer have varying clinicopathological presentations. This study is intended to know the difference in clinicopathological behavior of these two subsites. This retrospective study included 474 patients of which 232 patients had tongue cancer and 242 patients had buccal alveolar complex (BAC) cancer. Comparison between the pathological characters including pattern of nodal involvement was analyzed. Disease-free survival (DFS) and factors influencing the DFS were analyzed and compared using Cox regression analysis. Mean age of the study population was 52.7 years. Tongue oral squamous cell carcinoma (OSCC) differed significantly from BAC OSCC in terms of age of presentation, tumor staging, and perineural invasion. Among neck nodal involvement, tongue OSCC commonly involved level IIa ( < 0.001) whereas BAC involved level Ib ( < 0.001). At a median follow-up of 27 months, 141 patients had disease recurrence, tongue OSCC commonly recurred in neck ( = 0.008), and BAC OSCC relapsed at primary site ( = 0.001). Patients older than 45 years with BAC cancer had lesser risk of recurrence (HR, 0.30; 95% CI, 0.2-0.5; < 0.0001). Pathological tumor stage in tongue cancer (HR, 14.9; 95% CI, 2.6-84.8; = 0.002) and grade of tumor differentiation in BAC OSCC (HR, 9.2; 95% CI, 1.9-43.3; < 0.005) were the most significant factors that influenced tumor recurrence. There was a significant difference in factors influencing disease recurrence among tongue and BAC OSCC. Also, pattern of nodal metastasis and pattern of recurrence were different. Hence, further research on OSCC may be done site specific.
The online version contains supplementary material available at 10.1007/s13193-023-01750-8.
在印度,口腔癌是癌症相关死亡的主要原因。舌和颊黏膜是口腔癌的主要亚部位,具有不同的临床病理表现。本研究旨在了解这两个亚部位在临床病理行为上的差异。这项回顾性研究纳入了474例患者,其中232例患有舌癌,242例患有颊牙槽复合体(BAC)癌。分析了包括淋巴结受累模式在内的病理特征之间的差异。采用Cox回归分析对无病生存期(DFS)及影响DFS的因素进行分析和比较。研究人群的平均年龄为52.7岁。舌部口腔鳞状细胞癌(OSCC)在发病年龄、肿瘤分期和神经周围侵犯方面与BAC OSCC有显著差异。在颈部淋巴结受累方面,舌部OSCC通常累及Ⅱa区(<0.001),而BAC累及Ⅰb区(<0.001)。在中位随访27个月时,141例患者出现疾病复发,舌部OSCC常见于颈部复发(=0.008),而BAC OSCC在原发部位复发(=0.001)。年龄大于45岁的BAC癌患者复发风险较低(HR,0.30;95%CI,0.2 - 0.5;<0.0001)。舌癌的病理肿瘤分期(HR,14.9;95%CI,2.6 - 84.8;=0.002)和BAC OSCC的肿瘤分化程度(HR,9.2;95%CI,1.9 - 43.3;<0.005)是影响肿瘤复发的最显著因素。舌部和BAC OSCC在影响疾病复发的因素方面存在显著差异。此外,淋巴结转移模式和复发模式也不同。因此,可能需要针对OSCC的不同部位开展进一步研究。
在线版本包含可在10.1007/s13193 - 023 - 01750 - 8获取的补充材料。