评估浸润深度作为口腔鳞状细胞癌的连续预后因素
Evaluating Depth of Invasion as a Continuous Prognostic Factor in Oral Squamous Cell Carcinoma.
作者信息
Edri Nofar, Dudkiewicz Dean, Yaniv Dan, Ritter Amit, Strenov Yulia, Mizrachi Aviram, Bachar Gideon, Shpitzer Thomas, Yosefof Eyal
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Head Neck. 2025 Mar;47(3):856-866. doi: 10.1002/hed.27979. Epub 2024 Oct 30.
BACKGROUND
Depth of invasion (DOI) has a significant clinical impact on the staging system of oral squamous cell carcinoma (OSCC). We aimed to compare the prognostic impact of treating DOI as a continuous variable rather than a categorical one.
METHODS
A retrospective review of 277 OSCC patients surgically treated in a tertiary care center from 2000 to 2020, with a minimum 2-year follow-up. The analyses were performed using Cox and logistic regression.
RESULTS
DOI as a continuous variable significantly predicted mortality in both univariate (p < 0.001) and multivariate (p < 0.001) analyses. It was also a significant predictor of locoregional recurrence (multivariate p = 0.039) and occult lymph node metastasis (univariate p = 0.005, multivariate p = 0.04). Categorical analysis failed to demonstrate the same significance.
CONCLUSIONS
DOI as a continuous factor rather than a categorical one is significantly associated with mortality, locoregional recurrence, and occult lymph node metastasis. This innovative approach promotes personalized risk stratification and better decision-making.
背景
浸润深度（DOI）对口腔鳞状细胞癌（OSCC）的分期系统具有重大临床影响。我们旨在比较将DOI视为连续变量而非分类变量时对预后的影响。
方法
回顾性分析2000年至2020年在一家三级医疗中心接受手术治疗的277例OSCC患者，随访至少2年。采用Cox回归和逻辑回归进行分析。
结果
在单因素分析（p < 0.001）和多因素分析（p < 0.001）中，DOI作为连续变量均显著预测死亡率。它也是局部区域复发的显著预测因素（多因素分析p = 0.039）和隐匿性淋巴结转移的显著预测因素（单因素分析p = 0.005，多因素分析p = 0.04）。分类分析未能显示出相同的显著性。
结论
DOI作为连续因素而非分类因素与死亡率、局部区域复发和隐匿性淋巴结转移显著相关。这种创新方法有助于个性化风险分层和更好的决策制定。
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