Agne Guilherme Reimann, Kohler Hugo Fontan, Chulam Thiago Celestino, Pinto Clóvis Antônio Lopes, Vartanian José Guilherme, Kowalski Luiz Paulo
Cirurgia de Cabeça e Pescoço no Grupo PESCOP, Balneário Camboriú, SC, Brazil.
A.C. Camargo Cancer Center, Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2025 May 14;91 Suppl 1(Suppl 1):101624. doi: 10.1016/j.bjorl.2025.101624.
This study aims to determine the impact of MTCT on local recurrence and disease-specific survival in patients with locally advanced T3-T4 OCSCC and compare it with other clinicopathological variables.
A retrospective database analysis of patients diagnosed with locally advanced T3-T4 OCSCC surgically treated and submitted to intraoperative frozen section guiding the margin status. Survival was analyzed using the Kaplan-Meier estimator followed by the Cox model for multivariate analysis.
We analyzed 475 patients who met inclusion criteria: MTCT occurred in 29 patients (6.11%) and local recurrence was observed in 131 patients (27.6%). MTCT had an impact on univariate (HR = 2.205; 95% CI 1.243-3.914; p = 0.007) and multivariate (HR = 1.851; 95% CI 1.285-2.666; p = 0.001) analyses. Similar results were found for disease-specific survival: univariate (HZ = 1.669; 95% CI 1.056-2.635; p = 0.028) and multivariate (HZ = 1.307; 95% CI 0.816-2.092; p = 0.265) analyses. A total of 231 patients (48.6%) had died of cancer by the end of follow-up. The best predictor for compromised frozen sections was tumor depth of invasion.
Even after negative final margins, MTCT is an important factor associated with poorer outcome, and treatment intensification should be considered in these patients.
Level III.
本研究旨在确定母婴传播（MTCT）对局部晚期T3 - T4期口腔鳞状细胞癌（OCSCC）患者局部复发和疾病特异性生存的影响，并将其与其他临床病理变量进行比较。
对诊断为局部晚期T3 - T4期OCSCC且接受手术治疗并进行术中冰冻切片以指导切缘状态的患者进行回顾性数据库分析。使用Kaplan - Meier估计器分析生存情况，随后采用Cox模型进行多变量分析。
我们分析了475例符合纳入标准的患者：29例（6.11%）发生母婴传播，131例（27.6%）观察到局部复发。母婴传播在单变量（HR = 2.205；95% CI 1.243 - 3.914；p = 0.007）和多变量（HR = 1.851；95% CI 1.285 - 2.666；p = 0.001）分析中均有影响。疾病特异性生存也得到类似结果：单变量（HZ = 1.669；95% CI 1.056 - 2.635；p = 0.028）和多变量（HZ = 1.307；95% CI 0.816 - 2.092；p = 0.265）分析。到随访结束时，共有231例（48.6%）患者死于癌症。冰冻切片结果不佳的最佳预测因素是肿瘤浸润深度。
即使最终切缘阴性，母婴传播仍是与较差预后相关的重要因素，对于这些患者应考虑强化治疗。
三级。
