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可切除口腔鳞状细胞癌的临床结局及预后因素的影响

Clinical outcomes and impact of prognostic factors in resectable oral cavity squamous cell carcinoma.

作者信息

Abu Taha Shatha, Abu Hejleh Taher, Wahbeh Lina, Alzibdeh Abdulla, Berawi Mohammad, Qambar Mohamed, Mukahal Mohammad, Abuhijla Fawzi, Abu-Hijlih Ramiz, Taqash Ayat, Hussein Tariq, Alrousan Medyan, Saraireh Omar Al, Al-Gargaz Wisam, Al-Ibraheem Akram, Ghatasheh Hamza, Hosni Ali, Mohamad Issa

机构信息

Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan.

Department of Medical Oncology, King Hussein Cancer Center, Amman, Jordan.

出版信息

Front Oncol. 2024 Oct 11;14:1443367. doi: 10.3389/fonc.2024.1443367. eCollection 2024.

Abstract

PURPOSE

To evaluate clinical outcomes and prognostic factors in non-metastatic oral cavity squamous cell carcinoma (OCSCC) patients who underwent surgery with or without adjuvant therapy.

METHODS

From 2007 and 2018, 116 patients were analyzed. The primary endpoint was overall survival (OS), and secondary endpoints were disease-free survival (DFS), local failure (LF), regional failure (RF), and distant metastases (DM). Kaplan-Meier method and log-rank test assessed survival outcomes, while Cox proportional hazard tests analyzed prognostic factors.

RESULTS

Median patient age was 53 years, most were smokers (93.5%) and males (62.9%). Predominant subsite was the oral tongue (58.6%). Treatment included surgery alone (16.4%), adjuvant radiotherapy (46.6%), or adjuvant concurrent chemoradiotherapy (CCRT) (37%). The median follow-up time was 45.9 months. There were significant differences between groups in terms of gender (P=0.028) and RT dose (P=0.01). The 3-year OS, DFS, LF, RF and DM for the entire cohort were 60.9%, 55.1%, 20.11%, 8.43%, and 17.13%, respectively. Surgery alone yielded higher 3-year OS (81.4%) than adjuvant RT (70%) or adjuvant CCRT (41.4%), (p=0.012). Adjuvant CCRT correlated with higher LF compared to adjuvant RT and surgery alone groups (p=0.029). Lymphovascular invasion (LVI) impacted OS (HR=2.034, p=0.0498) and DM (HR=3.380, p=0.0132), while higher tumor grade increased DM likelihood (HR=8.477, p=0.0379).

CONCLUSIONS

This study reports OCSCC patient outcomes in Jordan across different treatment modalities. Adjuvant CCRT correlated with higher LF rates, and LVI impacted OS and DM, aligning with existing OCSCC treatment literature.

摘要

目的

评估接受手术联合或不联合辅助治疗的非转移性口腔鳞状细胞癌(OCSCC)患者的临床结局和预后因素。

方法

分析了2007年至2018年期间的116例患者。主要终点是总生存期(OS),次要终点是无病生存期(DFS)、局部复发(LF)、区域复发(RF)和远处转移(DM)。采用Kaplan-Meier法和对数秩检验评估生存结局,同时使用Cox比例风险检验分析预后因素。

结果

患者中位年龄为53岁,大多数为吸烟者(93.5%)和男性(62.9%)。主要发病部位是舌部(58.6%)。治疗方式包括单纯手术(16.4%)、辅助放疗(46.6%)或辅助同步放化疗(CCRT)(37%)。中位随访时间为45.9个月。各组在性别(P=0.028)和放疗剂量(P=0.01)方面存在显著差异。整个队列的3年OS、DFS、LF、RF和DM分别为60.9%、55.1%、20.11%、8.43%和17.13%。单纯手术的3年OS(81.4%)高于辅助放疗(70%)或辅助同步放化疗(41.4%),(p=0.012)。与辅助放疗和单纯手术组相比,辅助同步放化疗与更高的局部复发率相关(p=0.029)。淋巴管浸润(LVI)影响总生存期(HR=2.034,p=0.0498)和远处转移(HR=3.380,p=0.0132),而更高的肿瘤分级增加了远处转移的可能性(HR=8.477,p=0.0379)。

结论

本研究报告了约旦不同治疗方式下OCSCC患者的结局。辅助同步放化疗与更高的局部复发率相关,淋巴管浸润影响总生存期和远处转移,这与现有的OCSCC治疗文献一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fa/11502470/42b6b8ac0741/fonc-14-1443367-g001.jpg

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