THE CLINICAL-SIGNIFICANCE OF PATHOLOGICAL FINDINGS IN SURGICALLY RESECTED MARGINS OF THE PRIMARY TUMOR IN HEAD AND NECK-CARCINOMA
THE CLINICAL-SIGNIFICANCE OF PATHOLOGICAL FINDINGS IN SURGICALLY RESECTED MARGINS OF THE PRIMARY TUMOR IN HEAD AND NECK-CARCINOMA
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DOI：
10.1016/0360-3016(87)90095-2
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发表时间：
1987-06-01
影响因子：
7
通讯作者：
DRISCOLL, DL
中科院分区：
文献类型：
--
作者：
CHEN, TY;EMRICH, LJ;DRISCOLL, DL
本文回顾了1977年至1982年间在罗斯威尔公园纪念研究所接受口腔、口咽、下咽和喉癌手术治疗的270例连续患者，以确定原发肿瘤手术切缘的病理学结果与局部复发率和临床结局之间的关系。估计5年无病生存率为39%的患者手术切缘自由（10%.sbd.下咽，30%.sbd.oropharynx，40%.sbd.oral cavity，和53%.sbd.larynx）和7%的非自由手术切缘。切缘游离和高分化鳞癌患者的预后优于中分化和低分化癌患者。T1期和T2期病灶的局部复发率为17%，而T3期和T4期为27%。本研究的结果表明，原发性肿瘤的完全切除的病理证据是重要的，并应尝试获得病理清除。T3和T4期病变的局部复发率很高。有辅助治疗的指征，并建议术后放疗。
Two hundred seventy (270) consecutive surgical patients treated at Roswell Park Memorial Institute for carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx between 1977 and 1982 were reviewed to determine the relationship between pathological findings at the surgical margins of the primary tumor and the incidence of local recurrence and clinical outcome. The estimated 5-year disease-free survival rate was 39% for patients with free surgical margins (10%.sbd.hypopharynx, 30%.sbd.oropharynx, 40%.sbd.oral cavity, and 53%.sbd.larynx) and 7% for not-free surgical margins. Patients with free surgical margins and with well-differentiated squamous cell carcinoma had better prognosis than those patients with moderately- and poorly-differentiated carcinomas. The local recurrence rate for Stage T1 and T2 lesions with free surgical margins was 17%, compared with 27% for Stages T3 and T4. The results of this study indicate that pathological evidence of complete excision of the primary tumor is important and attempts should be made to obtain pathological clearance. The local recurrence rate for Stage T3 and T4 lesions is high. Adjuvant therapy is indicated and post-operative radiotherapy is recommended.