Chen Guanzheng, Kong Xiangpan, Feng Zhien, Kang Jia, Han Zhengxue, Li Bo
Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, No. 4 Tian Tan Xi Li, Dongcheng District, Beijing, 100050, P.R. China.
BMC Oral Health. 2025 Mar 13;25(1):383. doi: 10.1186/s12903-025-05694-z.
This study aimed to assess the prognosis of T1-2N0 stage tongue cancer patients who underwent surgery for the primary lesion without elective neck dissection and to identify the risk factors for prognosis.
We retrospectively analyzed early-stage tongue cancer patients in our center. Statistical analyses were performed using SPSS and R software.
The study reviewed 168 patients, revealing a 3-year overall survival rate of 90.5%, a 3-year cervical lymph node metastasis-free survival rate of 73.2%, and a 3-year disease-specific survival rate of 89.3%. A depth of invasion of 3 mm showed significant prognostic value for overall survival (P = 0.001), cervical lymph node metastasis-free survival (P = 0.002), and disease-specific survival (P < 0.001). Patients were categorized into four subgroups (thick T1, thin T1, thick T2, and thin T2) to further explore the prognostic significance of depth of invasion across different T stage categories. The combination of T stage and a 3 mm depth of invasion demonstrated significant prognostic value in univariate analysis for overall survival (P = 0.002), cervical lymph node metastasis-free survival (P = 0.010), and disease-specific survival (P < 0.001). COX regression analysis confirmed the statistical significance of T stage combined with a 3 mm depth of invasion for overall survival (OR = 10.653; 95% CI, 2.394 to 47.404; P = 0.002) and lymph node metastasis-free survival (OR = 3.016; 95% CI, 1.365 to 6.667; P = 0.006).
The findings highlight depth of invasion and T stage as key prognostic factors in early-stage tongue squamous cell carcinoma. Consideration of elective neck dissection is advised for patients with T2 tumors and a depth of invasion exceeding 3 mm to potentially enhance their prognosis.
The current research was registered in Chinese Clinical Trial Registry on April 8, 2021. The trial registration number is ChiCTR2100045188.
本研究旨在评估未行选择性颈清扫术的T1-2N0期舌癌患者原发灶手术后的预后，并确定预后的危险因素。
我们回顾性分析了本中心的早期舌癌患者。使用SPSS和R软件进行统计分析。
该研究纳入了168例患者，3年总生存率为90.5%，3年无颈淋巴结转移生存率为73.2%，3年疾病特异性生存率为89.3%。浸润深度3 mm对总生存（P = 0.001）、无颈淋巴结转移生存（P = 0.002）和疾病特异性生存（P < 0.001）具有显著的预后价值。将患者分为四个亚组（厚T1、薄T1、厚T2和薄T2），以进一步探讨不同T分期类别中浸润深度的预后意义。在单因素分析中，T分期与3 mm浸润深度相结合对总生存（P = 0.002）、无颈淋巴结转移生存（P = 0.010）和疾病特异性生存（P < 0.001）具有显著的预后价值。COX回归分析证实T分期与3 mm浸润深度相结合对总生存（OR = 10.653；95%CI，2.394至47.404；P = 0.002）和无淋巴结转移生存（OR = 3.016；95%CI，1.365至6.667；P = 0.006）具有统计学意义。
研究结果表明浸润深度和T分期是早期舌鳞状细胞癌的关键预后因素。对于T2期肿瘤且浸润深度超过3 mm的患者，建议考虑选择性颈清扫术，以可能改善其预后。
本研究于2021年4月8日在中国临床试验注册中心注册。试验注册号为ChiCTR2100045188。
