Prognostic value of clinicopathological parameters and outcome in 484 patients with oral squamous cell carcinoma: microvascular invasion (V plus ) is an independent prognostic factor for OSCC
Prognostic value of clinicopathological parameters and outcome in 484 patients with oral squamous cell carcinoma: microvascular invasion (V plus ) is an independent prognostic factor for OSCC
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DOI：
10.1007/s12094-012-0867-2
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发表时间：
2012-11-01
影响因子：
3.4
通讯作者：
Grimm, M.
中科院分区：
文献类型：
--
作者：
Grimm, M.
口腔鳞状细胞癌(OSCC)后的一些临床病理参数与预后、复发和生存有关。本研究的目的是回顾一次手术切除加或不加放、化疗或近距离放射治疗的口腔鳞癌患者的结果，并找出影响生存和局部控制的因素。我们回顾了1997-2010年间我科连续429例口腔鳞癌根治性切除和55例近距离放射治疗患者的临床资料。分析口腔鳞癌的病理参数，包括年龄、性别、部位分布、肿瘤大小、淋巴结转移、分级、微血管侵犯、淋巴管侵犯和远处转移。对每个变量进行描述性统计，并使用单变量Kaplan-Meier方法计算生存率。预后因素采用多变量Cox比例风险模型进行分析，平均肿瘤大小为10.9 mm(95%可信区间为9.6-12.3)。5年无瘤生存率为65%，总体5年生存率为62%。在单因素分析中，肿瘤大小、淋巴结侵犯、微血管侵犯和淋巴管侵犯的患者预后显著不良。多因素分析显示，肿瘤体积增大和微血管侵犯是独立的预后因素。这项以医院为基础的回顾性队列研究指出，在接受口腔鳞癌治疗的大型患者队列中，不同的临床病理预后因素对生存有影响。它强调肿瘤大小增加和微血管侵犯是预测口腔鳞癌患者生存的最独立的预后因素。
Several clinicopathological parameters have been implicated in prognosis, recurrence and survival, following oral squamous cell carcinoma (OSCC). The purpose of this retrospective study was to review the outcome of patients with oral cavity squamous cell carcinoma treated at a single institution by primary surgical resection with or without adjuvant radiotherapy or radiochemotherapy, or brachytherapy and to identify the factors affecting survival and locoregional control.We retrospectively reviewed the records of 429 consecutive patients after primary radical R0 tumor resection and 55 patients after brachytherapy in our department between 1997 and 2010. OSCC pathological parameters were analyzed including age, gender, site distribution, tumor size, lymph node involvement, grading, microvascular invasion, lymphatic vessel involvement, and distant metastasis. Descriptive statistics were calculated for each variable and survival was calculated using the univariate Kaplan-Meier method. Prognostic factors were analyzed using the multivariate Cox proportional hazard model.Average tumor size was 10.9 mm (95 % CI for the mean 9.6-12.3). Disease-free survival at 5 years was 65 % and overall 5-year survival was 62 %. On univariate analysis, patients with increased tumor size, lymph node involvement, microvascular invasion, and lymphatic vessel involvement had a significant poor prognosis. Multivariate analysis showed that independent prognostic factors were increased tumor size and microvascular invasion.This hospital-based retrospective cohort study points out different clinicopathological prognostic factors of survival in a large patient cohort treated for OSCC. It highlights increased tumor size and microvascular invasion as the most independent prognostic factors in predicting survival in patients with OSCC.