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手术治疗累及颞下窝的局部晚期口腔鳞状细胞癌的临床结果:一家三级癌症中心的经验

"Clinical Outcomes of Surgically Treated Locally Advanced Oral Cavity Squamous Cell Carcinoma with Infra-Temporal Fossa Involvement: A Tertiary Cancer Centre Experience".

作者信息

Daima Mahesh, Patel Pinakin, Lakhera Kamal Kishor, Singh Suresh, Choudhari Rajat, Babu Agil

机构信息

Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India.

出版信息

Indian J Surg Oncol. 2024 Dec;15(4):726-732. doi: 10.1007/s13193-024-01981-3. Epub 2024 Jun 11.

Abstract

Traditionally, patients with T4b oral cavity cancer have been deemed inoperable, leading to palliative treatments, primarily radiation and chemotherapy. In this study, we aim to critically evaluate the outcome of surgical intervention, specifically Infra-temporal fossa (ITF) clearance, about disease-free survival and overall survival rates. This is a retrospective observational study conducted over 2 years. 45 patients with clinical-radiological diagnosis of T4b disease, who had been subjected to surgery with ITF clearance were followed up for 2 years to check for recurrence and mortality. Locoregional recurrence was observed in 20 patients (44.4%) among which 3 patients additionally had distant metastasis. At the last follow-up, the overall mortality noted was 26.7%, with 33 patients still alive, out of which 25 were disease-free. No significant correlation was found between patient or tumor-related factors and recurrence rates except positive soft tissue and close bone margins. Survival analysis revealed a mean disease-free survival (DFS) of 18.57 months and an overall survival (OS) of 21.75 months. Surgical resection is a viable option for a few selected patients with locally advanced oral cavity cancer, with acceptable outcomes.

摘要

传统上,T4b期口腔癌患者被认为无法进行手术,只能进行姑息治疗,主要是放疗和化疗。在本研究中,我们旨在严格评估手术干预的结果,特别是颞下窝(ITF)清扫术对无病生存率和总生存率的影响。这是一项为期两年的回顾性观察研究。对45例经临床影像学诊断为T4b期疾病且接受了ITF清扫术的患者进行了为期两年的随访,以检查复发和死亡率情况。20例患者(44.4%)出现局部区域复发,其中3例还伴有远处转移。在最后一次随访时,总死亡率为26.7%,33例患者仍存活,其中25例无病生存。除了软组织阳性和切缘骨距近外,未发现患者或肿瘤相关因素与复发率之间存在显著相关性。生存分析显示,平均无病生存期(DFS)为18.57个月,总生存期(OS)为21.75个月。对于一些局部晚期口腔癌的特定患者,手术切除是一种可行的选择,且结果可接受。

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本文引用的文献

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Compartmental surgery for T4b oral squamous cell carcinoma involving the masticatory space.咀嚼间隙 T4b 期口腔鳞状细胞癌的分隔式手术治疗。
Curr Opin Otolaryngol Head Neck Surg. 2024 Apr 1;32(2):55-61. doi: 10.1097/MOO.0000000000000958. Epub 2024 Jan 8.
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Eur Arch Otorhinolaryngol. 2021 Aug;278(8):2961-2973. doi: 10.1007/s00405-020-06423-8. Epub 2020 Oct 15.
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