Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma
Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma
复制标题
DOI：
10.1016/j.ijom.2014.10.006
复制
发表时间：
2015-01-01
影响因子：
2.4
通讯作者：
Kowalski, L. P.
中科院分区：
文献类型：
--
作者：
Jardim, J. F.;Francisco, A. L. N.;Kowalski, L. P.
神经周围侵犯（PNI）和淋巴血管侵犯（LVI）与局部复发和淋巴结转移的风险相关。本研究的目的是评估 PM 和 LVI 对晚期舌和口底鳞状细胞癌患者预后的影响。选择了 142 名之前未接受过治疗的患者。这些患者接受了根治性手术，包括颈清扫术和辅助治疗。从医学图表中检索临床病理学数据，包括组织病理学和手术报告。进行单变量分析以评估研究变量对生存的影响。总生存率受到六种肿瘤相关因素的负面影响：T分期增加（P = 0.003）、超过两个临床阳性淋巴结（P = 0.002）、淋巴结转移的囊外扩散（P < 0.001）、肿瘤厚度（P = 0.04）、PNI（P < 0.001）和LVI（P = 0.012）。无病生存率受 PNI (P = 0.04)、淋巴结转移的囊外扩散 (P = 0.008) 和 N 分期 (P = 0.006) 的影响。多变量分析显示 PNI 是总生存期 (P = 0.01) 和无病生存期 (P = 0.03) 的独立预测因子。因此，口腔癌手术标本中 PNI 的存在对接受根治性手术和辅助放疗/放化疗的晚期肿瘤患者的生存结果具有显着影响。
Perineural invasion (PNI) and lymphovascular invasion (LVI) have been associated with the risk of local recurrences and lymph node metastasis. The aim of this study was to evaluate the prognostic impact of PM and LVI in patients with advanced stage squamous cell carcinoma of the tongue and floor of the mouth. One hundred and forty-two patients without previous treatment were selected. These patients underwent radical surgery with neck dissection and adjuvant treatment. Clinicopathological data were retrieved from the medical charts, including histopathology and surgery reports. Univariate analysis was performed to assess the impact of studied variables on survival. Overall survival was negatively influenced by six tumour-related factors: increasing T stage (P = 0.003), more than two clinically positive nodes (P = 0.002), extracapsular spread of lymph node metastasis (P < 0.001), tumour thickness (P = 0.04), PNI (P < 0.001), and LVI (P = 0.012). Disease-free survival was influenced by PNI (P = 0.04), extracapsular spread of lymph node metastasis (P = 0.008), and N stage (P = 0.006). Multivariate analysis showed PNI to be an independent predictor for overall survival (P = 0.01) and disease-free survival (P = 0.03). Thus the presence of PNI in oral carcinoma surgical specimens has a significant impact on survival outcomes in patients with advanced stage tumours submitted to radical surgery and adjuvant radiotherapy/radiochemotherapy.