Naegeli-Pullankavumkal Carolin, Ferrari Raphael, Gander Thomas, Lanzer Martin
Department of Oromaxillofacial Surgery, University Hospital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland.
Biomedicines. 2025 Mar 5;13(3):628. doi: 10.3390/biomedicines13030628.
Oral squamous cell carcinoma (OSCC) with bone infiltration is categorized as a T4 tumor regardless of its size. T4 tumors are an indication for postoperative radiotherapy, which could be overtreatment for small oral squamous cell carcinoma (SOSCC) with bone infiltration. A retrospective study of 189 patients with OSCC with the potential for mandibular infiltration was performed. The influence of the predictive variables on overall survival (OS) and disease-free survival (DFS) was assessed using the Kaplan-Meier method. A random forest approach was applied to determine the importance of each variable for survival in a multivariate context, and a partial correlation analysis was performed. A statistical analysis of the effects of covariates suggested only a small influence of bone infiltration on OS. Patients with bone infiltration had a 5-year OS of 69%, and those without bone invasion had a 5-year OS of 71%. Age, lymph node metastasis, depth of invasion (DOI), and tumor size had the most decisive prognostic influence on survival. Bone infiltration appears to have less prognostic explanatory power than other known variables regarding OS. Therefore, adjuvant therapy should be carefully evaluated.
伴有骨浸润的口腔鳞状细胞癌（OSCC）无论大小均被归类为T4肿瘤。T4肿瘤是术后放疗的指征，对于伴有骨浸润的小口腔鳞状细胞癌（SOSCC）而言，这可能属于过度治疗。对189例有下颌骨浸润可能的OSCC患者进行了一项回顾性研究。采用Kaplan-Meier法评估预测变量对总生存期（OS）和无病生存期（DFS）的影响。应用随机森林方法确定各变量在多变量背景下对生存的重要性，并进行偏相关分析。对协变量效应的统计分析表明，骨浸润对OS的影响很小。有骨浸润的患者5年总生存率为69%，无骨浸润的患者5年总生存率为71%。年龄、淋巴结转移、浸润深度（DOI）和肿瘤大小对生存具有最决定性的预后影响。关于总生存期，骨浸润似乎比其他已知变量具有更小的预后解释力。因此，应仔细评估辅助治疗。
