Department of Otolaryngology - Head & Neck Surgery, Weill Cornell Medicine, New York, NY, USA.
Department of Otolaryngology - Head & Neck Surgery, Weill Cornell Medicine, New York, NY, USA.
Am J Otolaryngol. 2024 May-Jun;45(3):104269. doi: 10.1016/j.amjoto.2024.104269. Epub 2024 Mar 20.
To determine the significance of depth of invasion as a predictor of recurrence and mortality in tongue and non-tongue early-stage oral cavity squamous cell carcinoma patients treated with surgery and no postoperative radiotherapy.
344 patients with oral cavity squamous cell carcinoma from 2005 to 2022 at a tertiary academic medical center were reviewed. Patients were included if they had newly diagnosed, previously untreated T1-T2N0 disease treated with surgery alone that was observed within a follow-up of 5 years. For each patient, anatomic site of oral cavity squamous cell carcinoma was categorized as either tongue or non-tongue. Cox proportional hazards regression analyses were performed to determine the association of depth of invasion with recurrence and mortality, with anatomic site, smoking status, and age at biopsy as covariates. Model assumptions were tested by statistical and graphical evaluation using Schoenfeld residuals.
Of 108 patients with T1-T2N0 disease, 78 (72.2 %) had tongue disease, and 30 (27.8 %) had non-tongue disease. Median follow-up was 18.2 months (range, 0.01-58.2 months). In the Cox proportional hazards models, with adjustment for anatomic site and other covariates, depth of invasion positively predicted recurrence (HR 1.16, 95 % CI: 1.01-1.32, p = 0.034) and death (HR 1.42, 95 % CI: 1.11-1.83, p = 0.006).
Depth of invasion is an independent predictor of recurrence and death across early-stage tongue and non-tongue squamous cell carcinoma. Therefore, depth of invasion may indicate a need for more aggressive treatment than surgery alone, such as postoperative radiotherapy, even in the absence of other adverse features on pathology within the early-stage population.
确定侵袭深度作为预测未接受术后放疗的手术治疗的早期舌和非舌口腔鳞状细胞癌患者复发和死亡的意义。
回顾了 2005 年至 2022 年在一家三级学术医疗中心治疗的 344 例口腔鳞状细胞癌患者。如果患者患有新诊断的、未经治疗的 T1-T2N0 疾病，且仅接受手术治疗，并且在 5 年的随访期内观察到，那么患者将被纳入研究。对于每例患者，口腔鳞状细胞癌的解剖部位被分为舌或非舌。采用 Cox 比例风险回归分析来确定侵袭深度与复发和死亡的关系，以解剖部位、吸烟状况和活检时年龄作为协变量。通过使用 Schoenfeld 残差的统计和图形评估来测试模型假设。
在 108 例 T1-T2N0 疾病患者中，78 例（72.2%）为舌疾病，30 例（27.8%）为非舌疾病。中位随访时间为 18.2 个月（范围，0.01-58.2 个月）。在 Cox 比例风险模型中，调整解剖部位和其他协变量后，侵袭深度与复发（HR 1.16，95%CI：1.01-1.32，p=0.034）和死亡（HR 1.42，95%CI：1.11-1.83，p=0.006）显著相关。
侵袭深度是早期舌和非舌鳞状细胞癌复发和死亡的独立预测因素。因此，即使在早期人群的病理学中没有其他不良特征，侵袭深度也可能表明需要比单纯手术更积极的治疗，例如术后放疗。
