Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients.
Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients.
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DOI：
10.1186/1758-3284-2-9
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发表时间：
2010-04-20
期刊：
影响因子：
--
通讯作者：
Hopper C
中科院分区：
文献类型：
--
作者：
Jerjes W;Upile T;Petrie A;Riskalla A;Hamdoon Z;Vourvachis M;Karavidas K;Jay A;Sandison A;Thomas GJ;Kalavrezos N;Hopper C
口腔鳞状细胞癌的发病率仍然很高。口腔癌和口咽癌是世界上第六大常见癌症。口腔鳞状细胞癌的预后、复发和生存与几个临床病理参数有关。在这项回顾性分析中，我们研究了115例T1/T2期口腔鳞状细胞癌的临床病理参数，并与肿瘤相关原因引起的复发和死亡进行了比较。研究方案由UCL/UCLH联合人类研究伦理委员会批准。患者的数据被输入到形式表格中，并通过间隔抽样进行验证和检查。这些领域包括一系列与手术切缘状态相关的临床、手术和组织病理学变量。数据收集还包括复发、死亡原因、死亡日期和上次临床审查。死亡原因分为4类：（1）局部扩散死亡，（2）远处转移死亡，（3）支气管肺炎死亡，（4）导致心肺衰竭的任何非肿瘤事件死亡。患者人群包括65名男性和50名女性。他们首次诊断为口腔鳞状细胞癌的平均年龄为61.7岁。三分之二的患者是白人。原发部位主要在舌、口底、颊粘膜和牙槽。大多数已确定的OSCC是低风险的（T1 N 0和T2 N 0）。所有患者均行一期切除+颈淋巴结清扫术，必要时行重建。22例患者需要辅助放疗。病理分析显示，一半的患者有中度分化的口腔鳞状细胞癌。pTNM与cTNM略有不同，显示70.4%的患者患有低风险OSCC。107例患者最终实现肿瘤清除。随访3年生存率为74.8%，5年生存率为72.2%。在23名男性和20名女性中确定了复发。复发组首次诊断的平均年龄为59.53岁。最常见的口腔部位包括舌侧缘和口底。复发与临床N期疾病相关。对本组病例的手术切缘进行了评估，发现17例无粘连性侵犯，30例切缘发育不良，21例血管侵犯，9例神经侵犯，3例骨性侵犯。37例患者存在重度异型增生。仅8例患者实现肿瘤清除。复发组的平均肿瘤浸润深度为7.6 mm。一个有趣的发现是，5/11例死于远处转移的患者的原发病在舌。淋巴结疾病比较显示，8/10例死于局部转移的患者和8/11例死于远处转移的患者有临床淋巴结受累。与病理性淋巴结疾病（pTNM）相比，死于局部和远处转移的患者分别有10/10和10/11例患有淋巴结疾病。所有死于局部和远处转移的患者在原发肿瘤切除后均显示复发。口腔鳞状细胞癌的总体预后较差，原发部位复发的趋势很高，并扩展到累及颈部淋巴结。几个临床病理学参数可以用来评估结果，复发和总生存。
The incidence of oral squamous cell carcinoma remains high. Oral and oro-pharyngeal carcinomas are the sixth most common cancer in the world. Several clinicopathological parameters have been implicated in prognosis, recurrence and survival, following oral squamous cell carcinoma. In this retrospective analysis, clinicopathological parameters of 115 T1/T2 OSCC were studied and compared to recurrence and death from tumour-related causes. The study protocol was approved by the Joint UCL/UCLH committees of the ethics for human research. The patients' data was entered onto proformas, which were validated and checked by interval sampling. The fields included a range of clinical, operative and histopathological variables related to the status of the surgical margins. Data collection also included recurrence, cause of death, date of death and last clinic review. Causes of death were collated in 4 categories (1) death from locoregional spread, (2) death from distant metastasis, (3) death from bronchopulmonary pneumonia, and (4) death from any non-tumour event that lead to cardiorespiratory failure. The patients' population comprised 65 males and 50 females. Their mean age at the 1st diagnosis of OSCC was 61.7 years. Two-thirds of the patients were Caucasians. Primary sites were mainly identified in the tongue, floor of mouth (FOM), buccal mucosa and alveolus. Most of the identified OSCCs were low-risk (T1N0 and T2N0). All patients underwent primary resection ± neck dissection and reconstruction when necessary. Twenty-two patients needed adjuvant radiotherapy. Pathological analysis revealed that half of the patients had moderately differentiated OSCC. pTNM slightly differed from the cTNM and showed that 70.4% of the patients had low-risk OSCC. Tumour clearance was ultimately achieved in 107 patients. Follow-up resulted in a 3-year survival of 74.8% and a 5-year survival of 72.2%. Recurrence was identified in 23 males and 20 females. The mean age of 1st diagnosis of the recurrence group was 59.53 years. Most common oral sites included the lateral border of tongue and floor of mouth. Recurrence was associated with clinical N-stage disease. The surgical margins in this group was evaluated and found that 17 had non-cohesive invasion, 30 had dysplasia at margin, 21 had vascular invasion, 9 had nerve invasion and 3 had bony invasion. Severe dysplasia was present in 37 patients. Tumour clearance was achieved in only 8 patients. The mean depth of tumour invasion in the recurrence group was 7.6 mm. An interesting finding was that 5/11 patients who died of distant metastasis had their primary disease in the tongue. Nodal disease comparison showed that 8/10 patients who died of locoregional metastasis and 8/11 patients who died from distant metastasis had clinical nodal involvement. Comparing this to pathological nodal disease (pTNM) showed that 10/10 patients and 10/11 patients who died from locoregional and distant metastasis, respectively, had nodal disease. All patients who died from locoregional and distant metastasis were shown to have recurrence after the primary tumour resection. Squamous cell carcinoma of the oral cavity has a poor overall prognosis with a high tendency to recur at the primary site and extend to involve the cervical lymph nodes. Several clinicopathological parameters can be employed to assess outcome, recurrence and overall survival.
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DOI：
10.1002/ssu.2980050507
发表时间：
1989-01-01
期刊：
SEMINARS IN SURGICAL ONCOLOGY
影响因子：
--
作者：
FAKIH, AR;RAO, RS;PATEL, AR
通讯作者：
PATEL, AR
影响因子：
158.5
作者：
Bernier, J;Domenge, C;van Glabbeke, M
通讯作者：
van Glabbeke, M
影响因子：
6.2
作者：
Greenberg, JS;El Naggar, AK;Myers, JN
通讯作者：
Myers, JN
影响因子：
3.3
作者：
Hayashi, T;Ito, J;Katsura, K
通讯作者：
Katsura, K
影响因子：
3.7
作者：
Campana, Luca G.;Mocellin, Simone;Nitti, Donato
通讯作者：
Nitti, Donato