Consistent multimodality approach to oral cavity and high-risk oropharyngeal cancer in veterans.
Consistent multimodality approach to oral cavity and high-risk oropharyngeal cancer in veterans.
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DOI：
10.1016/j.amjoto.2021.103166
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发表时间：
2021-11
影响因子：
2.5
通讯作者：
Sandulache, Vlad C.
中科院分区：
文献类型：
--
作者：
Hernandez, David J.;Alam, Bahar;Kemnade, Jan O.;Huang, Andrew T.;Chen, Albert C.;Sandulache, Vlad C.
与烟草接触相关的高危口咽鳞状细胞癌(OPSCC)仍然难以治疗，因为与口腔鳞状细胞癌(OCSCC)相似，局部复发率很高。目前的NCCN指南允许这种疾病的手术治疗，但现代的肿瘤学和功能数据仍然很少。我们试图在退伍军人队列中比较和对比OPSCC和OCSCC手术治疗的肿瘤学和功能方面的考虑。我们对2017至2020年间在Michael E.DeBakey退伍军人事务医疗中心接受治疗的患者进行了回顾，采用同质、多模式算法进行治疗。与OCSCC肿瘤相比，OPSCC肿瘤表现出更高的神经侵袭率(p<；0.05)和结外侵犯(p=0.02)。对于OPSCC患者，对NCCN辅助治疗指南的依从性较低，主要是因为以前的放疗率较高；当NCCN指南建议时，75%的患者可以再次接受放射治疗。在100%的OPSCC患者和0%的OCSCC患者中，全舌切除伴随着全喉切除。高危OPSCC的手术切除和游离皮瓣重建产生的肿瘤学结果与OCSCC相似，但并发症发生率相似，但总体功能状态较低。注重快速愈合的重建可以实现高复发率和最小的治疗延迟。证据级别：4级。
High-risk oropharyngeal squamous cell carcinoma (OPSCC) associated with tobacco exposure remains difficult to treat due to high rates of locoregional recurrence similar to oral cavity squamous cell carcinoma (OCSCC). Current NCCN guidelines allow for surgical management of this disease, but oncologic and functional data in the modern era remain scarce. We sought to compare and contrast oncologic and functional considerations for surgical management of OPSCC and OCSCC in a cohort of Veterans. We conducted a retrospective review of patients treated at the Michael E. DeBakey Veterans Affairs Medical Center between 2017 and 2020, treated using a homogenous, multi-modality algorithm. OPSCC tumors presented with a higher rate of perineural invasion (p < 0.05) and extranodal extension (p = 0.02) compared to OCSCC tumors. Compliance with NCCN guidelines for adjuvant treatment were lower for OPSCC patients primarily due to a higher rate of previous irradiation; re-irradiation could be delivered in 75% of patients when recommended by NCCN guidelines. Total glossectomy was accompanied by concomitant total laryngectomy in 100% of OPSCC patients and 0% of OCSCC. Surgical resection and free flap reconstruction of high-risk OPSCC generates oncologic outcomes comparable to OCSCC with comparable complication rates but a lower overall functional status. Reconstruction focused on rapid healing allows for high-rates of re-irradiation and minimal treatment delays. Level of evidence: level 4.
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口腔癌治疗的当前概念——手术。
影响因子：
4.8
作者：
Shah, Jatin P.;Gil, Ziv
通讯作者：
Gil, Ziv
影响因子：
6.2
作者：
Dahlstrom, Kristina R.;Calzada, Gabriel;Hanby, Jennifer D.;Garden, Adam S.;Glisson, Bonnie S.;Li, Guojun;Roberts, Dianna B.;Weber, Randal S.;Sturgis, Erich M.
通讯作者：
Sturgis, Erich M.
DOI：
10.1158/1078-0432.ccr-17-0721
发表时间：
2018-04-01
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Sandulache VC;Michikawa C;Kataria P;Gleber-Netto FO;Bell D;Trivedi S;Rao X;Wang J;Zhao M;Jasser S;Myers JN;Pickering CR
通讯作者：
Pickering CR
影响因子：
3.7
作者：
Liao, Chun-Ta;Wen, Yu-Wen;Yen, Tzu-Chen
通讯作者：
Yen, Tzu-Chen
DOI：
10.1158/1078-0432.ccr-11-2260
发表时间：
2012-01-01
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Skinner HD;Sandulache VC;Ow TJ;Meyn RE;Yordy JS;Beadle BM;Fitzgerald AL;Giri U;Ang KK;Myers JN
通讯作者：
Myers JN