Outcome of local failures after oral cancer - recurrence vs. second primary
Outcome of local failures after oral cancer - recurrence vs. second primary
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DOI：
10.1111/j.1600-0714.2010.00905.x
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发表时间：
2010-10-01
影响因子：
3.3
通讯作者：
Boysen, Morten
中科院分区：
文献类型：
--
作者：
Rennemo, Erlend;Zatterstrom, Ulf;Boysen, Morten
背景/目的：在口腔癌成功治疗的患者中发现新的上呼吸道消化道粘膜恶性肿瘤（UADT）的高风险。这些患者的预后尚不清楚。典型的失败可能位于第一个肿瘤的位置，即局部复发；或单独作为第二原发肿瘤（SPT）。目前尚不清楚这两种类型的局部衰竭是否有不同的预后。研究设计：采用前瞻性收集数据超过25年的纵向观察队列研究。方法：对151例T1N0M0口腔鳞状细胞癌患者的局部复发率和UADT SPTs进行分析。比较局部复发和局部SPT患者失败后的生存。结果：所有患者的5年肿瘤特异性生存率为86.3%。151例患者中，20例有局部复发，16例有UADT SPT。局部失败后，局部复发的中位生存期为17.2个月，UADT SPT（癌症特异性）的中位生存期为18.9个月。从原发性肿瘤治疗到局部复发的中位时间为42个月，而UADT SPTs为125个月。随着时间的推移，两种肿瘤类型的表现呈相似的线性模式。结论：局部失败后预后较差。无论失败是局部复发还是第二原发肿瘤，生存率均无差异。生存和呈现模式的相似性表明这两种实体在生物学上可能是相似的。
Background/objective:A high risk of new mucosal malignancies of the upper aerodigestive tract (UADT) is seen in patients successfully treated for oral cancer. The prognosis is unclear for these patients. A typical failure may be located at the site of the first tumor i.e. a local recurrence; or separately as a second primary tumor (SPT). It is unknown whether these two types of local failures have different prognosis.Study design:Longitudinal observational cohort study employing prospectively collected data over 25 years.Methods:The rate of local recurrences and UADT SPTs was analyzed in 151 patients previously treated for T1N0M0 oral squamous cell carcinoma. Survival after failure was compared between patients with local recurrence and local SPT.Results:All patients had a 5-year cancer specific survival of 86.3%. Of the 151 patients, 20 had a local recurrence, and 16 had an UADT SPT. After a local failure, survival was median 17.2 months for local recurrence and 18.9 for UADT SPT (cancer specific). Time from primary tumor treatment to local recurrence was median 42 and months vs. 125 months for UADT SPTs. A similar linear pattern of presentation over time was seen for both tumor types.Conclusion:Outcome was poor after the date of the local failure. No difference in survival was seen whether the failure was a local recurrence or a second primary tumor. The similarity in survival and pattern of presentation suggests that these two entities may be biologically analogous.