Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients.
Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients.
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颈部观察与择期颈清扫术治疗临床 T1/2N0 口腔鳞状细胞癌：232 名患者的回顾性研究
DOI：
10.21147/j.issn.1000-9604.2017.03.03
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发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
Liang Y
中科院分区：
文献类型：
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作者：
Liu X;Lao X;Liang L;Zhang S;Li K;Liao G;Liang Y
目的早期（cT1/2N0）口腔鳞状细胞癌（OSCC）的治疗一直是一个有争议的问题。本研究的目的是比较颈部观察（OBS）和选择性颈部清扫（END）治疗cT1/2N0型OSCC患者的临床结果。方法对232例cT1/2N0型OSCC患者进行回顾性研究。在这些患者中，181人接受END治疗，51人接受OBS治疗。采用Kaplan-Meier法绘制各组5年总生存率（OS）、疾病特异性生存率（DSS）和无复发生存率（RFS）的生存曲线，并采用Log-rank检验进行比较。结果END组与OBS组5年OS和DSS比较，差异无统计学意义（OS: 89.0% vs. 88.2%， P=0.906; DSS: 92.3% vs. 92.2%， P=0.998）。然而，END组的5年RFS率高于OBS组（90.1%比76.5%，P=0.009）。OBS组（7/51）隐匿性转移患者的5年OS率（57.1%比64.1%，P=0.839）和DSS率（71.4%比74.4%，P=0.982）与END组（39/181）相似。在局部复发患者中，OBS组（7/51）的5年OS（57.1%比11.1%，P=0.011）和DSS（71.4%比22.2%，P=0.022）均高于END组（9/181）。结论OBS策略可获得与END相同的5年OS和DSS。在密切随访下，OBS政策可能是临床t1 / 2no OSCC患者的一种可行的治疗选择。
Objective The management of early-stage (cT1/2N0) oral squamous cell carcinoma (OSCC) remains a controversial issue. The aim of this study was to compare the clinical outcomes of neck observation (OBS) and elective neck dissection (END) in treating patients with cT1/2N0 OSCC. Methods A total of 232 patients with cT1/2N0 OSCC were included in this retrospective study. Of these patients, 181 were treated with END and 51 with OBS. The survival curves of 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates were plotted using the Kaplan-Meier method for each group, and compared using the Log-rank test. Results There was no significant difference in 5-year OS and DSS rates between END and OBS groups (OS: 89.0% vs. 88.2%, P=0.906; DSS: 92.3% vs. 92.2%, P=0.998). However, the END group had a higher 5-year RFS rate than the OBS group (90.1% vs. 76.5%, P=0.009). Patients with occult metastases in OBS group (7/51) had similar 5-year OS rate (57.1% vs. 64.1%, P=0.839) and DSS rate (71.4% vs. 74.4%, P=0.982) to those in END group (39/181). In the regional recurrence patients, the 5-year OS rate (57.1% vs. 11.1%, P=0.011) and DSS rate (71.4% vs. 22.2%, P=0.022) in OBS group (7/51) were higher than those in END group (9/181). Conclusions The results indicated that OBS policy could obtain the same 5-year OS and DSS as END. Under close follow-up, OBS policy may be an available treatment option for patients with clinical T1/2N0 OSCC.