Po W Y, Wei W I, Yue M W, Kwong C T, Lai K L
Department of Surgery, University of Hong Kong, China.
Chin Med J (Engl). 1997 Nov;110(11):859-64.
To evaluate the results of primary surgical treatment of carcinoma of oral tongue in Hong Kong.
Patients who had undergone primary surgical treatment of oral tongue carcinoma in Queen Mary Hospital were reviewed.
There were 112 patients in this study. The first sites of tumor recurrence were 10 (9%) local, 25 (22%) nodal, 3 (3%) locoregional, 5 (5%) distant, 1 (1%) local and distant, 3 (3%) nodal and distant, and 1 (1%) neck extranodal site. Of the 63 T1-2 N0 M0 patients, the regional recurrence rate was 9% for elective neck dissection compared with 47% for "watchful waiting" (Chi-square test, P = 0.0008). The regional recurrence related mortality was 3% for elective neck dissection compared with 23% for "watchful waiting" (Fisher's test, P = 0.02). The 5-year actuarial survival rate was 86% for elective neck dissection compared with 55% for "watchful waiting" (Wilcoxon, P = 0.01).
Local and regional recurrences were the main sites of treatment failure. Elective neck dissection has significant benefits in the reduction of regional failure and improvement of survival. Elective selective I-III neck dissection have to be considered in patients with stage I and stage II oral tongue carcinoma.
评估香港舌癌原发手术治疗的结果。
回顾在玛丽医院接受舌癌原发手术治疗的患者。
本研究中有112例患者。肿瘤复发的首发部位为局部10例（9%）、区域淋巴结25例（22%）、局部区域3例（3%）、远处转移5例（5%）、局部和远处转移1例（1%）、区域淋巴结和远处转移3例（3%）以及颈部结外部位1例（1%）。在63例T1-2 N0 M0患者中，选择性颈清扫术的区域复发率为9%，而“观察等待”的复发率为47%（卡方检验，P = 0.0008）。选择性颈清扫术的区域复发相关死亡率为3%，“观察等待”为23%（Fisher检验，P = 0.02）。选择性颈清扫术的5年精算生存率为86%，“观察等待”为55%（Wilcoxon检验，P = 0.01）。
局部和区域复发是治疗失败的主要部位。选择性颈清扫术在降低区域复发和提高生存率方面有显著益处。对于I期和II期舌癌患者，必须考虑选择性I-III区颈清扫术。
