IMPLICATIONS OF TUMOR IN RESECTION MARGINS FOLLOWING SURGICAL-TREATMENT OF SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK
IMPLICATIONS OF TUMOR IN RESECTION MARGINS FOLLOWING SURGICAL-TREATMENT OF SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK
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DOI：
10.1111/j.1365-2273.1993.tb00807.x
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发表时间：
1993-02-01
影响因子：
2.1
通讯作者：
LLUCH, ES
中科院分区：
文献类型：
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作者：
COOK, JA;JONES, AS;LLUCH, ES
头颈部鳞状细胞癌初次手术治疗后切除边缘出现肿瘤被认为会对预后产生不利影响。为了证实这一点，我们对 478 名接受初次手术治疗的头颈部鳞状细胞癌患者进行了回顾，并将他们细分为切除后切缘阳性的患者和切缘阴性的患者。使用单变量和多变量统计方法来分析生存数据以及与切除切缘阳性相关的各种参数。我们发现，如果切除切缘呈阳性，则 5 年生存率会降低 (P < 0.025)。阳性切除切缘的存在也与肿瘤复发时间（P < 0.001）和淋巴结复发生存率（P < 0.001）显着相关。使用 Cox 多变量分析与生存显着相关的其他因素包括肿瘤部位（P < 0.005）、淋巴结包膜外破裂（P < 0.05）、组织学（P < 0.05）和病理 T 分期（P < 0.05）。单变量分析显示，阳性切缘的存在与患者的年龄、性别、肿瘤部位、肿瘤分化程度和淋巴结状态之间没有显着相关性。采用多元Logistic回归分析，患者的一般状况（P < 0.01）和肿瘤部位（P < 0.05）显着相关。结果支持了头颈部鳞状细胞癌初次消融手术时应尽一切努力获得阴性切除边缘的理念。
Presence of tumour at the resection margin following primary surgical treatment for squamous cell carcinoma of the head and neck is thought to adversely affect prognosis. To confirm this we performed a review of 478 patients treated by primary surgery for squamous cell carcinoma of the head and neck and sub-divided them into those exhibiting postive margins and those with negative margins following resection.Uni-variate and multi-variate statistical methods were used to analyse survival figures and a variety of parameters associated with the presence of positive resection margins. We found 5-year survival was decreased if resection margins were found to be positive (P < 0.025). The presence of positive resection margins was also significantly associated with time to tumour recurrence (P < 0.001) and survival with nodal recurrence (P < 0.001). Other factors which were significantly associated with survival using Cox's multi-variate analysis were site of tumour (P < 0.005), nodal extracapsular rupture (P < 0.05), histology (P < 0.05) and pathological T-stage (P < 0.05).Uni-variate analysis revealed no significant associations between the presence of positive margins and the patient's age, sex, tumour site, degree of tumour differentiation, and nodal status, though using multiple logistic regression, the general condition of the patient (P < 0.01) and the tumour site P < 0.05) were significantly related.The results support the concept that every effort should be made to obtain negative resection margins when undertaking primary ablative surgery for squamous cell carcinoma of the head and neck.