THE NUMBER OF PATHOLOGICALLY POSITIVE LYMPH NODES AND PATHOLOGICAL TUMOR DEPTH PREDICTS PROGNOSIS IN PATIENTS WITH POORLY DIFFERENTIATED SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY
THE NUMBER OF PATHOLOGICALLY POSITIVE LYMPH NODES AND PATHOLOGICAL TUMOR DEPTH PREDICTS PROGNOSIS IN PATIENTS WITH POORLY DIFFERENTIATED SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY
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DOI：
10.1016/j.ijrobp.2011.03.060
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发表时间：
2011-11-15
影响因子：
7
通讯作者：
Yen, Tzu-Chen
中科院分区：
文献类型：
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作者：
Kang, Chung-Jan;Lin, Chien-Yu;Yen, Tzu-Chen
目的：这项回顾性研究的目的是双重的：（1）调查的临床结果与低分化口腔鳞状细胞癌患者的预后因素和（2）确定特定的预后亚组，可能有助于指导治疗decision.Methods和材料：我们研究了102例低分化口腔鳞状细胞癌。所有患者术后随访至少24个月或直至死亡。5年局部控制率、颈部控制率、远处转移率、无病生存率、疾病特异性生存率和总生存率为主要结局指标。结果：5年局部控制率为79%，颈部控制率为64%，远处转移率为27%，无病生存率为48%，疾病特异性生存率为52%，总生存率为42%。多变量分析显示，病理阳性淋巴结数量（≥ 4 vs. ≥ 11 mm vs.< 11 mm）是远处转移、疾病特异性生存率和总生存率的重要预测因素。两个预测因子的组合（26.5%，27/102）与颈部控制较差独立相关（p = 0.0319），远处转移（p < 0.0001），无病（p < 0.0001），疾病特异性（p < 0.0001），总生存期（p < 0.0001）率。在低分化口腔鳞状细胞癌患者中，存在至少4个病理学阳性淋巴结和病理学肿瘤深度>= 11 mm鉴定了具有不良临床结果的受试者子集。携带这两种危险因素的患者是开发新治疗方法的合适候选人。(C)2011 Elsevier Inc.
Purpose: The objective of this retrospective study was twofold: (1) to investigate prognostic factors for clinical outcomes in patients with poorly differentiated oral cavity squamous cell carcinoma and (2) to identify specific prognostic subgroups that may help to guide treatment decisions.Methods and Materials: We examined 102 patients with poorly differentiated oral cavity squamous cell carcinoma. All patients were followed for at least 24 months after surgery or until death. The 5-year rates of local control, neck control, distant metastasis, disease-free, disease-specific, and overall survival served as main outcome measures.Results: The 5-year rates were as follows: local control (79%), neck control (64%), distant metastases (27%), disease-free survival (48%), disease-specific survival (52%), and overall survival (42%). Multivariable analysis showed that the number of pathologically positive nodes (>= 4 vs. = 11mm(vs. < 11 mm) was a significant predictor of distant metastasis, disease-specific survival, and overall survival rates. The combination of the two predictors (26.5%, 27/102) was independently associated with poorer neck control (p = 0.0319), distant metastasis (p < 0.0001), and disease-free (p < 0.0001), disease-specific (p < 0.0001), and overall survival (p < 0.0001) rates.Conclusions: In patients with poorly differentiated oral cavity squamous cell carcinoma, the presence of at least 4 pathologically positive lymph nodes and of a pathological tumor depth >= 11 mm identifies a subset of subjects with poor clinical outcomes. Patients carrying both risk factors are suitable candidates for the development of novel therapeutic approaches. (C) 2011 Elsevier Inc.