Laboratory of Oral Pathology, School of Dentistry, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
Department of Oral Diagnosis, School of Dentistry, Universidade Evangélica de Goiás, Anápolis, Goiás, Brazil.
J Oral Pathol Med. 2024 Jul;53(6):358-365. doi: 10.1111/jop.13546. Epub 2024 May 14.
To assess the influence of diagnosis and referral provided by specialists in oral diagnosis on disease-free survival and overall survival of patients with oral cancer.
A cohort of 282 patients with oral cancer treated at a regional cancer hospital from 1998 to 2016 was analyzed retrospectively. The referral register of the patients was analyzed and assigned to two groups: (1) those referred by oral diagnosis specialists (n = 129), or (2) those referred by nonspecialized professionals (n = 153). The cancer treatment evolution was assessed from the patients' records, and the outcome was registered concerning cancer recurrence and death. Sociodemographic and clinicopathological variables were explored as predictors of disease-free survival and overall survival.
Group 1 exhibited lower T stages and a reduced incidence of regional and distant metastases. Surgery was performed in 75.2% of cases in Group 1, while in Group 2, the rate was 60.8%. Advanced T stages and regional metastases reduced the feasibility of surgery. Higher TNM stages and tumor recurrence were associated with decreased disease-free survival, while surgical intervention was a protective factor. Higher TNM stage had a negative impact on the overall survival.
Specialized oral diagnosis did not directly impact disease-free survival and overall survival and did not influence the indication of surgery in oral cancer; however, it was associated with the diagnosis of early tumors and better prognosis.
评估口腔诊断专家提供的诊断和转诊对口腔癌患者无病生存率和总生存率的影响。
回顾性分析了 1998 年至 2016 年在一家地区癌症医院治疗的 282 例口腔癌患者的队列。分析了患者的转诊登记册，并将其分为两组：（1）由口腔诊断专家转诊的患者（n=129），或（2）由非专业人员转诊的患者（n=153）。从患者的记录中评估癌症治疗的演变，并登记癌症复发和死亡的结果。探索了社会人口统计学和临床病理学变量作为无病生存率和总生存率的预测因素。
第 1 组的 T 分期较低，局部和远处转移的发生率降低。第 1 组中 75.2%的病例进行了手术，而第 2 组中这一比例为 60.8%。较高的 T 分期和局部转移降低了手术的可行性。较高的 TNM 分期和肿瘤复发与无病生存率降低相关，而手术干预是保护因素。较高的 TNM 分期对总生存率有负面影响。
专门的口腔诊断并未直接影响无病生存率和总生存率，也未影响口腔癌的手术适应证；然而，它与早期肿瘤的诊断和更好的预后相关。
