Outcome analysis of patients with well-differentiated oral cavity squamous cell carcinoma
Outcome analysis of patients with well-differentiated oral cavity squamous cell carcinoma
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DOI：
10.1016/j.oraloncology.2011.07.018
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发表时间：
2011-11-01
期刊：
影响因子：
4.8
通讯作者：
Yen, Tzu-Chen
中科院分区：
文献类型：
--
作者：
Kang, Chung-Jan;Liao, Chun-Ta;Yen, Tzu-Chen
高分化口腔鳞状细胞癌（OSCC）的预后优于低分化肿瘤。这项回顾性研究的目的是确定高分化 OSCC 患者的预后因素。对 467 例接受根治性手术和颈清扫术的高分化 OSCC 患者的 5 年结果进行了分析。在整个队列中，病理性淋巴结转移（pN+ 与 pN0）的存在是 5 年结果的独立预测因子。在 pN0 患者中，肿瘤深度（>= 8 mm）是多变量分析中 5 年生存率的唯一独立预后因素（无病生存 [DFS]，P = 0.001，风险比 [HR] = 2.634，95% 置信区间 [95% CI] = 1.496-4.636；疾病特异性生存 [DSS]，P < 0.001，HR = 6.794，95% CI = 2.364-19.525）。在 pN+ 患者中，IV/V 级颈部淋巴结转移（DFS，P < 0.001，HR = 47.483，95% CI = 8.942-252.122；DSS，P < 0.001，HR = 14.301，95% CI = 5.337-38.323），且 >= 3 个阳性淋巴结（DFS，P = 0.037，HR = 2.107，95% CI = 1.047-4.242；DSS，P = 0.044，HR = 2.093，95% CI = 1.020-4.295）与 5 年结果独立相关。我们的结果表明，针对高分化 OSCC 患者的定制治疗方法应考虑 pN0 或 pN+ 疾病的存在。 (C) 2011 Elsevier Ltd. 保留所有权利。
The prognosis of well-differentiated oral cavity squamous cell carcinoma (OSCC) is better than less-well-differentiated neoplasms. The aim of this retrospective study was to identify prognostic factors in patients with well-differentiated OSCC. The 5-year outcomes of 467 patients with well-differentiated OSCC who underwent radical surgery and neck dissection were analyzed. In the entire cohort, the presence of pathological node metastases (pN+ vs. pN0) was an independent predictor of 5-year outcomes. In pN0 patients, tumor depth (>= 8 mm) was the only independently prognostic factor for 5-year survival rates on multivariable analysis (disease-free survival [DFS], P = 0.001, hazard ratio [HR] = 2.634, 95% confidence interval [95% CI] = 1.496-4.636; disease-specific survival [DSS], P < 0.001, HR = 6.794, 95% CI = 2.364-19.525). In pN+ patients, level IV/V neck nodal metastases (DFS, P < 0.001, HR = 47.483, 95% CI = 8.942-252.122; DSS, P < 0.001, HR = 14.301, 95% CI = 5.337-38.323), and >= 3 positive nodes (DFS, P = 0.037, HR = 2.107, 95% CI = 1.047-4.242; DSS, P = 0.044, HR = 2.093, 95% CI = 1.020-4.295) were independently associated with 5-year outcomes. Our results suggest that a tailored treatment approach in well-differentiated OSCC patients should take into account the presence of either pN0 or pN+ disease. (C) 2011 Elsevier Ltd. All rights reserved.