Established prognostic variables in N0 oral carcinoma
Established prognostic variables in N0 oral carcinoma
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DOI：
10.1016/j.otohns.2006.05.751
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发表时间：
2006-11-01
影响因子：
3.4
通讯作者：
Gullane, Patrick J.
中科院分区：
文献类型：
--
作者：
Clark, Jonathan R.;Naranjo, Natalie;Gullane, Patrick J.
目的：研究口腔癌和临床阴性颈部患者预后变量的实用性。研究设计：回顾性队列研究。方法：对105例口腔癌患者隐匿性转移的分布进行评估，这些患者没有临床或放射学证据证明存在淋巴结疾病。研究了淋巴结转移、复发和生存的预测因素。结果：34%的患者发生隐匿性颈部转移。肿瘤厚度是隐匿性转移的唯一独立预测因子，薄（5mm）的肿瘤分别有10%和46%的局部疾病发生率（P = 0.001）。淋巴结转移和神经周围浸润是生存的重要预测因素。结论：厚瘤患者发生淋巴结转移的风险高，择期颈部清扫术有可能获益。晚期原发性疾病应考虑进行全面的颈部清扫。意义：肿瘤厚度是口腔癌局部转移最重要的预测指标。(C) 2006年美国耳鼻喉头颈外科学会基金会。版权所有。
OBJECTIVES: To examine the utility of established prognostic variables in patients with oral carcinoma and a clinically negative neck.STUDY DESIGN: Retrospective cohort study.METHODS: The distribution of occult metastases was assessed in 105 oral cancer patients with no clinical or radiological evidence of nodal disease. Predictors for nodal metastases, recurrence, and survival were examined.RESULTS: Occult neck metastases occurred in 34 percent of patients. Tumor thickness was the only independent predictor of occult metastases, with thin (5 mm) tumors having a 10 percent and 46 percent incidence of regional disease, respectively (P = 0.001). Nodal metastases and perineural invasion were significant predictors of survival.CONCLUSION: Patients with thick tumors are at high risk of nodal metastases and are likely to benefit from elective neck dissection. Comprehensive neck dissection should be considered in advanced primary disease.SIGNIFICANCE: Tumor thickness is the most important predictor of occult regional metastases in oral cavity cancer. (C) 2006 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.