Damazo Benjamin J, Punjabi Nihal A, Liu Yuan F, Inman Jared C
Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States.
Case Western Reserve University School of Medicine, Cleveland, OH, United States.
Front Oral Health. 2024 Aug 6;5:1426709. doi: 10.3389/froh.2024.1426709. eCollection 2024.
Recurrence and survival in early T-stage oral tongue squamous cell carcinoma (OTSCC) may be impacted by histopathologic risk factors. This study aims to examine which of these factors predict long-term outcomes of T1 and T2 OTSCC.
A retrospective review of T1 and T2 OTSCC patients treated with surgery at a single tertiary care center was conducted. Multivariate regression and Kaplan-Meier survival plots were used to identify predictors of recurrence and compare disease-free survival respectively.
100 consecutive patients were studied. Of these, 51 were staged pT1, 49 pT2, 69 pN0, 10 pN1, and 21 pN2. Multivariate regression analysis revealed that >4 nodes was the strongest predictor of overall recurrence [odds ratio 1.68 (1.23-2.28), = 0.001], while >4 nodes [odds ratio 1.14 (1.09-1.85), = 0.008] and pT2 [odds ratio 1.15 (1.01-1.30), = 0.033] were predictors of local recurrence (R2 = 0.112). Five-year disease-free survival was not significantly impacted by any risk factors except for the number of positive nodes-86% for ≤4 nodes vs. 20% for >4 nodes ( < 0.001)-and pathologic T-stage-90% for pT1 vs. 75% for pT2 ( = 0.035) regardless of adjuvant radiation and/or chemotherapy use.
Patients who underwent adjuvant radiation and/or chemotherapy had similar survival to those who did not despite having worse overall tumor prognostic factors. Adding adjuvant therapy may equalize some high-risk histopathologic factors. In the highest risk patients-specifically those with pathologic >4 nodes and pT2 staging-adjuvant therapy should be considered.
早期T分期口腔舌鳞状细胞癌（OTSCC）的复发和生存情况可能受组织病理学危险因素的影响。本研究旨在探讨这些因素中哪些可预测T1和T2期OTSCC的长期预后。
对在一家三级医疗中心接受手术治疗的T1和T2期OTSCC患者进行回顾性分析。采用多因素回归分析和Kaplan-Meier生存曲线分别确定复发的预测因素并比较无病生存期。
共研究了100例连续患者。其中，51例为pT1期，49例为pT2期，69例为pN0期，10例为pN1期，21例为pN2期。多因素回归分析显示，淋巴结转移>4枚是总体复发的最强预测因素[比值比1.68（1.23 - 2.28），P = 0.001]，而淋巴结转移>4枚[比值比1.14（1.09 - 1.85），P = 0.008]和pT2期[比值比1.15（1.01 - 1.30），P = 0.033]是局部复发的预测因素（R2 = 0.112）。除阳性淋巴结数量外，五年无病生存期不受任何危险因素的显著影响 - 淋巴结≤4枚者为86%，而>4枚者为20%（P < 0.001），以及病理T分期 - pT1期为90%，pT2期为75%（P = 0.035），无论是否使用辅助放疗和/或化疗。
尽管总体肿瘤预后因素较差，但接受辅助放疗和/或化疗的患者与未接受者的生存率相似。添加辅助治疗可能会平衡一些高危组织病理学因素。对于最高风险患者，特别是那些病理上淋巴结>4枚且为pT2分期的患者，应考虑辅助治疗。
