Clinicopathological features, management and outcome of patients with poorly-differentiated oral and oropharyngeal squamous cell carcinoma
Clinicopathological features, management and outcome of patients with poorly-differentiated oral and oropharyngeal squamous cell carcinoma
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低分化口腔和口咽鳞状细胞癌患者的临床病理特征、治疗和结局
DOI：
10.1016/j.jcms.2017.06.013
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发表时间：
2017-09-01
影响因子：
3.1
通讯作者：
Han, Zhengxue
中科院分区：
文献类型：
--
作者：
Feng, Zhien;Xu, Qiao Shi;Han, Zhengxue
背景资料：本研究旨在探讨中国北方地区口腔及口咽部低分化鳞状细胞癌（OOSCC）的临床病理特征、危险因素及治疗方法。方法：回顾性分析2236例中118例OOSCC患者的临床资料。结果：考克斯回归分析显示，在中国北方地区，118例OOSCC患者的临床病理特征、危险因素及治疗方法与预后密切相关。结论：口腔及口咽部低分化鳞状细胞癌的临床病理特征、危险因素及治疗方法与预后密切相关。（风险比（HR）：2.561，95%CI：1.064e6.164，p = 0.036）和淋巴结比率（LNR）（HR：3.915，95%CI：1.797e8.530，p = 0.001）是5年疾病特异性生存期（DSS）的独立预测因素。LNR > 0.036、口咽部位、晚期临床分期构成危险分层模型。风险评分>= 2的患者被确定为高风险人群，风险评分为0或1的患者被确定为低风险人群。接受手术加同步放化疗（CCRT）的高危人群患者的5年DSS明显优于仅接受手术的患者（60.0% vs. 20.0%，p = 0.016）。然而，在低风险人群中，单独接受手术的患者表现出类似的5年DSS（68.2%）相比，接受手术加放疗（RT）（68.2%）或手术加CCRT（50.0%）（p = 0.907）。结论：高LNR，口咽部位和晚期临床分期构成了一个模型的风险分层低分化OOSCC患者。如果存在两个或两个以上的危险因素，手术和辅助放化疗可以提供最好的预后。(C)2017年欧洲颅颌面外科协会。由爱思唯尔有限公司出版。保留所有权利。
Background: The purpose of this study was to explore the clinicopathological features, risk factors, and management of poorly differentiated oral and oropharyngeal squamous cell carcinoma (OOSCC) patients in the northern Chinese population.Method: A total of 118 poorly differentiated OOSCC patients from 2236 consecutive cases were retrospectively enrolled in this study.Results: Cox regression analysis showed that site (hazard ratio (HR): 2.561, 95% confidence interval (CI): 1.064e6.164, p = 0.036) and lymph node ratio (LNR) (HR: 3.915, 95% CI: 1.797e8.530, p = 0.001) were independent predictive factors for 5-year disease-specific survival (DSS). LNR > 0.036, oropharynx site, and advanced clinical stage formulate a model of risk stratification. The patients with a risk score of >= 2 were identified as the high-risk population, and patients with a risk score of 0 or 1 were identified as the low-risk population. Patients in the high-risk population who underwent surgery plus concurrent chemoradiotherapy (CCRT) had markedly better 5-year DSS than those who only underwent surgery (60.0% vs. 20.0%, p = 0.016). However, patients in the low-risk population who underwent surgery alone exhibited a similar 5-year DSS (68.2%) compared with those who received surgery plus radiotherapy (RT) (68.2%) or surgery plus CCRT (50.0%) (p = 0.907).Conclusions: High LNR, oropharynx site and advanced clinical stage constitute a model of risk stratification for patients with poorly differentiated OOSCC. If two or more risk factors are present, surgery and adjuvant chemoradiotherapy can give the best prognosis. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.