Prognosis of oral squamous cell carcinoma patients with level IV/V metastasis: An observational study
Prognosis of oral squamous cell carcinoma patients with level IV/V metastasis: An observational study
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DOI：
10.1016/j.jcms.2016.10.011
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发表时间：
2017-01-01
影响因子：
3.1
通讯作者：
Komori, Takahide
中科院分区：
文献类型：
--
作者：
Hasegawa, Takumi;Shibuya, Yasuyuki;Komori, Takahide
目的：本研究的目的是回顾性描述 IV/V 级转移的口腔鳞状细胞癌 (OSCC) 患者的特征和结果，并评估转移和预后的潜在危险因素之间的多变量关系。材料和方法：我们评估了 291 名患者（178 名男性和 113 名女性；平均年龄为 65.9 +/- 13.5 岁）。研究了临床病理学数据、IV/V 级转移的发生时间以及临床病程。结果：23 名患者 (7.9%) 出现 IV/V 级转移。初次治疗时首次发生 IV/V 级转移时的 3 年总生存率为 27.3%，发生异时颈部转移时的 3 年总生存率为 57.1%，肿瘤复发时的 3 年总生存率为 40.0%。口腔舌肿瘤亚位、高N分期、异时颈部转移发生时的颈清扫术以及复发是IV/V级转移的独立危险因素。结论：我们在此证明了上述 IV/V 级转移风险因素之间的多变量关系及其对 OSCC 患者的预后意义。口腔舌肿瘤、高N分期、异时颈部转移或复发时行颈清扫术是IV/V级转移的危险因素，包膜外扩散阳性、存在多发淋巴结转移、中分化或低分化是不良预后因素。 (C) 2016 年欧洲颅颌面外科协会。由爱思唯尔有限公司出版。保留所有权利。
Purpose: The objectives of this study were to retrospectively describe the characteristics and outcomes of patients with oral squamous cell carcinoma (OSCC) with level IV/V metastases, and to evaluate the multivariate relationships among potential risk factors for metastasis and prognosis.Materials and methods: We evaluated 291 patients (178 men and 113 women; mean age, 65.9 +/- 13.5 years). Clinicopathological data, time of development of level IV/V metastases, and clinical course were investigated.Results: Twenty-three patients (7.9%) developed level IV/V metastases. The 3-year overall survival rates when level IV/V metastasis first developed were 27.3% upon initial treatment, 57.1% when metachronous neck metastasis developed, and 40.0% when the tumor recurred. Oral tongue tumor subsite, high N staging, neck dissection when metachronous neck metastasis developed, as well as recurrence were independent risk factors for level IV/V metastasis. Conclusion: We demonstrate here the multivariate relationships among the risk factors indicated above for level IV/V metastasis and their prognostic significance for patients with OSCC. Oral tongue tumors, high N staging, and neck dissection upon the occurrence of metachronous neck metastasis or recurrence were risk factors for level IV/V metastasis and positive extracapsular spread, presence of multiple lymph metastases, and moderate or poor differentiation were poor prognostic factors. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.