Alberto Grammatica, Marco Ravanelli, Michele Tomasoni, Carlo Conti, Aurora Pinacoli, Anna Bozzola, Davide Farina, Davide Mattavelli, Cesare Piazza
Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili di Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
Unit of Radiology, ASST Spedali Civili di Brescia, Brescia, Italy.
Eur Arch Otorhinolaryngol. 2025 Jan;282(1):417-425. doi: 10.1007/s00405-024-08929-x. Epub 2024 Sep 4.
In the present study, we investigated how tumor distance from midline (TDFM) and depth of invasion (DOI) may affect survival outcomes after compartmental tongue surgery (CTS) for oral tongue squamous cell carcinoma (OTSCC).
A retrospective series of cT2-T3 OTSCC treated with upfront CTS at our Department from 2010 to 2021 was evaluated. Radiological and pathological DOI and TDFM were correlated. The main outcomes were overall (OS) and loco-regional recurrence free survival (LRRFS). The linear relationship between DOI and TDFM with 2-year OS and LRRFS was tested. Survival estimates were obtained by the Kaplan-Meier method. Univariate analysis was performed for variables of interest, and results expressed in terms of hazard ratios and 95% confidence intervals.
A total of 64 patients underwent CTS and neck dissection. No significant difference was found between pathological (pDOI) and radiological DOI (rDOI) (p = 0.321) or between pathological (pTDFM) and radiological TDFM (p = 0.435). Two- and 5-year OS and LRRFS were 85.7% and 70.4%, 84.3% and 76.1%, respectively. A linear and significant relationship with OS (p = 0.020) and LRRFS (p = 0.013) was found for pDOI; although linear, the relationship between pTDFM was not statistically significant for either survival outcomes. Once categorized, the ideal cut-off for pDOI according to OS was set at 10 mm (p = 0.023).
In patients undergoing CTS for primary OTSCC, magnetic resonance-derived rDOI represents an accurate estimate of pDOI, In contrast, TDFM was not associated with OS suggesting that the median raphe is a safe deep margin for CTS.
BS/231,009 retrospectively registered.
在本研究中，我们调查了口腔舌鳞状细胞癌（OTSCC）行分区舌手术（CTS）后，肿瘤与中线的距离（TDFM）和浸润深度（DOI）如何影响生存结果。
对2010年至2021年在我院接受 upfront CTS治疗的一系列cT2 - T3 OTSCC患者进行回顾性研究。对放射学和病理学的DOI及TDFM进行相关性分析。主要结局为总生存期（OS）和无局部区域复发生存期（LRRFS）。检验DOI和TDFM与2年OS及LRRFS之间的线性关系。采用Kaplan - Meier法获得生存估计值。对感兴趣的变量进行单因素分析，结果以风险比和95%置信区间表示。
共有64例患者接受了CTS及颈部清扫术。病理DOI（pDOI）与放射学DOI（rDOI）之间（p = 0.321）或病理TDFM（pTDFM）与放射学TDFM之间（p = 0.435）均未发现显著差异。2年和5年的OS及LRRFS分别为85.7%和70.4%、84.3%和76.1%。发现pDOI与OS（p = 0.020）和LRRFS（p = 参考0.013）呈线性且显著相关；尽管pTDFM与生存结局呈线性关系，但对两者均无统计学意义。分类后，根据OS确定的pDOI理想截断值为10 mm（p = 0.023）。
对于接受原发性OTSCC CTS的患者，磁共振衍生的rDOI是pDOI的准确估计值。相比之下，TDFM与OS无关，提示中线是CTS安全的深部切缘。
BS/231,009（回顾性注册）
