Shintani S, Matsuura H, Hasegawa Y, Nakayama B, Hasegawa H
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Japan.
Anticancer Res. 1995 Jul-Aug;15(4):1573-6.
Locoregional control of tongue cancer has improved. However, the incidence of distant metastases is rising, and a significant increase in long-term survival has failed to materialize. In our study, twenty-two (9.9%) of the 223 patients presented distant metastases. The incidence of distant metastases was significantly related to the tumor size and the regional lymph node involvement. Large (T4) lesions showed a higher risk for having distant metastases than T1-3 lesions (p < 0.01). The group with pathologic presence of disease in the neck lymph nodes had more than three times as many distant metastases as did those with pathologic absence (8.1% versus 26.8%). Moreover, 8 out of 13 (61.5%) patients with more than four pathological positive lymph node had distant metastasis. Tongue carcinoma patients with T4 lesion and four or more positive nodes had the highest risk of distant metastases and these patients may benefit from adjuvant systemic treatment.
舌癌的局部区域控制情况有所改善。然而，远处转移的发生率正在上升，长期生存率并未显著提高。在我们的研究中，223例患者中有22例（9.9%）出现远处转移。远处转移的发生率与肿瘤大小和区域淋巴结受累情况显著相关。大的（T4）病变发生远处转移的风险高于T1-3病变（p < 0.01）。颈部淋巴结病理检查有疾病的组远处转移的数量是病理检查无疾病组的三倍多（8.1%对26.8%）。此外，13例病理检查阳性淋巴结超过4个的患者中有8例（61.5%）发生远处转移。患有T4病变且有4个或更多阳性淋巴结的舌癌患者发生远处转移的风险最高，这些患者可能从辅助全身治疗中获益。
