Worrall S F, Corrigan M
Department of Oral & Maxillofacial Surgery, Leeds Dental Institute
Ann R Coll Surg Engl. 1995 Sep;77(5):332-6.
The results of an audit of a single surgeon's experience of oral squamous cell carcinoma over a 5-year period is reported and the benefits of adopting a prospective computerized malignancy database outlined. Oral cancer occurred mainly in the 7th decade of life, women were on average 5 years younger than men at presentation. Men were affected 1.7 times as often as women and presented with more advanced disease than women. The mean delay from referral to histological diagnosis was 6.4 days and the mean delay from diagnosis to treatment was 25.8 days. The majority of patients consumed alcohol and smoked tobacco, but a significant minority were lifelong nondrinkers and non-smokers. While the incidence of most site-specific oral cancers were similar to the national averages the incidences of alveolar and floor of mouth cancers were higher than expected. The TNM stage at presentation was an unreliable prognostic indicator of future disease progression and outcome. Auditing treatment and outcome is a major component of the recent proposals to centralise the provision of cancer services in dedicated cancer centres and units (1). Audit can only be effective if it is based on current, reliable and accurate data and this can only be achieved by the use of a computerised malignancy database.
报告了对一位外科医生5年口腔鳞状细胞癌治疗经验的审计结果,并概述了采用前瞻性计算机化恶性肿瘤数据库的益处。口腔癌主要发生在70岁左右,女性就诊时平均比男性小5岁。男性患病几率是女性的1.7倍,且病情比女性更严重。从转诊到组织学诊断的平均延迟为6.4天,从诊断到治疗的平均延迟为25.8天。大多数患者有饮酒和吸烟习惯,但有相当一部分人终生不饮酒、不吸烟。虽然大多数特定部位口腔癌的发病率与全国平均水平相似,但牙槽癌和口底癌的发病率高于预期。就诊时的TNM分期并不能可靠地预测未来疾病的进展和结局。审计治疗情况和结果是近期关于在专门的癌症中心和单位集中提供癌症服务提议的一个主要组成部分(1)。只有基于当前、可靠和准确的数据,审计才会有效,而这只能通过使用计算机化恶性肿瘤数据库来实现。