Gujrathi D, Kerr P, Anderson B, Nason R
Department of Otolaryngology, Head and Neck Surgery, University of Manitoba, Winnipeg.
J Otolaryngol. 1996 Jun;25(3):145-9.
Treatment outcome was retrospectively assessed in 106 patients with squamous cell carcinoma of the oral tongue registered in the population-based Manitoba Cancer Registry between January 1979 and December 1992. Twenty-six percent were diagnosed with stage I lesions, while 33%, 16%, and 24% were stage II, III, and IV, respectively. Most patients with stage I and II disease were treated with either surgery alone (57%) or in combination with radiotherapy (29%). Advanced lesions were generally treated with radiotherapy alone (37%) or in combination with surgery (35%). Actuarial survival at 5 years was 44% for all patients, and 64%, 46%, 42%, and 16% for stages I to IV, respectively. Over 90% of the 35 treatment failures occurred within 24 months. The initial sites of recurrence were the neck in 22 patients, the primary site in 16 patients, and distant metastases in 5 patients. At the time of death, disease was present above the clavicles in 62%, and metastases were identified in 22%. Locoregional control remains a significant problem in oral cancer. Elective treatment of the neck, resection of the primary with negative surgical margins, and the use of combined modality treatment in advanced stages of disease may help reduce treatment failure.
对1979年1月至1992年12月间在基于人群的曼尼托巴癌症登记处登记的106例舌鳞状细胞癌患者的治疗结果进行了回顾性评估。26%的患者被诊断为I期病变，而II期、III期和IV期患者分别占33%、16%和24%。大多数I期和II期疾病患者接受单纯手术治疗（57%）或联合放疗（29%）。晚期病变通常接受单纯放疗（37%）或联合手术治疗（35%）。所有患者的5年精算生存率为44%，I至IV期患者的5年精算生存率分别为64%、46%、42%和16%。35例治疗失败患者中，超过90%在24个月内出现复发。复发的初始部位为颈部22例，原发部位16例，远处转移5例。死亡时，62%的患者锁骨以上存在疾病，22%发现有转移。局部区域控制仍然是口腔癌的一个重要问题。对颈部进行选择性治疗、切除手术切缘阴性的原发灶以及在疾病晚期使用联合治疗方式可能有助于减少治疗失败。
