Teixeira Daniel Naves Araujo, Lau Fabio, Oliveira Vanessa Carvalho de, Couto Eduardo Vieira, Maahs Thomas Peter, Lima Carmen Silvia Passos, Chone Carlos Takahiro
Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
Braz J Otorhinolaryngol. 2025 May 3;91(5):101622. doi: 10.1016/j.bjorl.2025.101622.
To estimate patients' overall and disease-free survival with squamous cell carcinoma of the oral cavity, oropharynx, and larynx, and assess the influence of primary local staging and histopathological features on these outcomes.
Retrospective data analysis of 102 patients with head and neck squamous cell carcinoma who underwent exclusive surgery as the initial treatment modality. p16 analysis was not evaluated. Exclusion criteria included patients with synchronous or metachronous tumors, those undergoing adjuvant or neoadjuvant chemotherapy or radiotherapy, and those with prior surgery at the exact site. Univariate and multivariate Cox Regression analyses were performed to evaluate outcome-related factors. Survival curves were estimated using the Kaplan-Meier method.
The majority presented early stage I and II (83.4%), T1/T2 tumors (86.2%), N0 (95.1%), and all M0. The primary sites were mainly the larynx (46.1%) and oral cavity (41.2%). The mean overall survival was 71.76 months, with survival rates at 1-, 2-, 3-, 4-, and 5-years of 95.9%, 88.2%, 85.5%, 80.4%, and 74.7%, respectively. The mean disease-free survival was 68.2 months, with rates at 1-, 2-, 3-, 4-, and 5-years of 87.5%, 85.1%, 82.2%, 76.6%, and 69.3%, respectively. Active smoking was associated with a higher risk of death (HR = 9.4, p < 0.001) and recurrence (HR = 9.7, p < 0.001). Active smoking patients with perineural invasion presented worse overall and disease-free survival. Positive margins were associated with reduced disease-free survival.
Exclusive surgery in the early stages (I and II) emerges as a practical approach. Stage, primary site, margins, perineural invasion, lymphovascular invasion, and smoking cessation were the significant prognostic factors that affected patient outcomes.
2C.
评估口腔、口咽和喉鳞状细胞癌患者的总生存期和无病生存期，并评估原发局部分期和组织病理学特征对这些预后的影响。
对102例接受单纯手术作为初始治疗方式的头颈部鳞状细胞癌患者进行回顾性数据分析。未评估p16分析。排除标准包括患有同步或异时性肿瘤的患者、接受辅助或新辅助化疗或放疗的患者以及在确切部位有过先前手术的患者。进行单因素和多因素Cox回归分析以评估与预后相关的因素。使用Kaplan-Meier方法估计生存曲线。
大多数患者为早期I期和II期（83.4%）、T1/T2肿瘤（86.2%）、N0（95.1%）且均为M0。原发部位主要是喉（46.1%）和口腔（41.2%）。平均总生存期为71.76个月，1年、2年、3年、4年和5年生存率分别为95.9%、88.2%、85.5%、80.4%和74.7%。平均无病生存期为68.2个月，1年、2年、3年、4年和5年的比率分别为87.5%、85.1%、82.2%、76.6%和69.3%。主动吸烟与更高的死亡风险（HR = 9.4，p < 0.001）和复发风险（HR = 9.7，p < 0.001）相关。有神经周围侵犯的主动吸烟患者的总生存期和无病生存期更差。切缘阳性与无病生存期降低相关。
早期（I期和II期）单纯手术是一种可行的方法。分期、原发部位、切缘、神经周围侵犯、脉管侵犯和戒烟是影响患者预后的重要预后因素。
2C。
