Triple-positive pathologic findings in oral cavity cancer are related to a dismal prognosis
Triple-positive pathologic findings in oral cavity cancer are related to a dismal prognosis
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DOI：
10.1002/lary.25463
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发表时间：
2015-09-01
期刊：
影响因子：
2.6
通讯作者：
Chuang, Hui-Ching
中科院分区：
文献类型：
--
作者：
Lin, Yu-Tsai;Chien, Chih-Yen;Chuang, Hui-Ching
目的/假设神经周围侵犯（PNI）、淋巴管侵犯（LVI）和淋巴结的囊外扩散（ECS）是口腔癌患者的不良组织病理学因素。我们分析了PNI、LVI和ECS联合治疗对口腔癌患者的临床影响。研究设计对三级转诊中心至少有5年随访数据的以手术为主的口腔癌患者进行回顾性分析。方法共纳入2006年至2008年期间在我院连续接受手术的554例诊断为口腔鳞状细胞癌的患者。分析临床特征、5年生存率和局部/区域控制率。结果女性41例，男性513例。病理表现为 PNI、LVI 或 ECS 的患者的 5 年总生存率分别为 58.4%、50.4% 和 31.4%。同时患有 ECS 和 PNI 或同时患有 ECS 和 LVI 的患者的 5 年总生存率分别为 31.5% 和 22.2%。具有三阳性状态（PNI、LVI 和 ECS）的患者的 5 年总生存率仅为 20.0%。 ECS 和 PNI 或 ECS 和 LVI 患者的 5 年局部/区域控制率分别为 26% 和 44.4%；对于所有三个因素，该比例为 26.7%。 结论 三阳性状态（PNI、LVI、ECS）、ECS 和 PNI 或 ECS 和 LVI 的患者的 5 年局部/区域控制率、5 年总体生存率和疾病特异性生存率非常低。需要采取新的干预措施来改善这些临床结果。证据水平4。喉镜，125：E300-E305，2015
Objectives/HypothesisPerineural invasion (PNI), lymphovascular invasion (LVI), and extracapsular spread (ECS) of lymph nodes are adverse histopathologic factors among patients with oral cancer. We analyzed the clinical impact of the combination of PNI, LVI, and ECS among patients with oral cancer.Study DesignRetrospective analysis of patients with oral cancer that was treated primarily with surgery with at least 5 years of follow-up data in a tertiary referral center.MethodsIn total, 554 patients diagnosed with oral cavity squamous cell carcinoma who underwent operations consecutively between 2006 and 2008 in our hospital were enrolled. Clinical characteristics, 5-year survival rates, and local/regional control rates were analyzed.ResultsThere were 41 females and 513 males. Patients with PNI, LVI, or ECS presented pathologically had 5-year overall survival rates of 58.4%, 50.4%, and 31.4%, respectively. Patients with both ECS and PNI or both ECS and LVI presented had 5-year overall survival rates of 31.5% and 22.2%, respectively. Patients presenting with triple-positive status (PNI, LVI, and ECS) had only a 20.0% 5-year overall survival rate. The 5-year local/regional control rate for patients with both ECS and PNI or both ECS and LVI was 26% and 44.4%, respectively; for all three factors, it was 26.7%.ConclusionPatients with triple-positive status (PNI, LVI, ECS), ECS and PNI, or ECS and LVI experienced very low 5-year local/regional control rates, 5-year overall, and disease-specific survival rates. Novel interventions are necessary to improve these clinical outcomes.Level of Evidence4. Laryngoscope, 125:E300-E305, 2015