Prognostic factors affecting outcome in lower gingival carcinoma
Prognostic factors affecting outcome in lower gingival carcinoma
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DOI：
10.1097/00005537-199611000-00006
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发表时间：
1996-11-01
期刊：
影响因子：
2.6
通讯作者：
Weber, RS
中科院分区：
文献类型：
--
作者：
Overholt, SM;Eicher, SA;Weber, RS
下牙龈鳞状细胞癌是一种罕见的病变，经常侵犯下颌骨，以确定影响局部疾病控制和总生存率的因素，对155例既往未经治疗的患者进行了回顾性分析，大于3 cm的原发性病变（P = .021）和持续疾病阳性手术切缘（P = 0.027）与局部控制率下降有关，晚期T分期对生存率有不利影响（P = .001）、初始和最终手术切缘阳性（P = .004）、下颌骨侵犯（P = .014）和颈部转移（P < .001）。下颌骨切除的范围、肿瘤延伸到下牙龈以外、原发区域最近拔牙、神经周围浸润和组织学分级并不影响局部控制或生存。尽管下牙龈癌倾向于累及下颌骨，但我们的研究结果表明，在预测局部疾病控制方面，肿瘤大小比下颌骨浸润更重要，较大的肿瘤有更大的局部复发倾向和更差的生存率，需要更广泛的手术切除。
Squamous cell carcinoma of the lower gingiva is a rare lesion that frequently invades the mandible, To determine the factors that affect local disease control and overall survival, a retrospective review of 155 previously untreated patients was performed, Primary lesions larger than 3 cm (P = .021) and persistently disease-positive surgical margins (P = .027) were found to be associated with decreased local control rates, Survival was adversely affected by advanced T stage (P = .001), positive initial and final surgical margins (P = .004), mandibular invasion (P = .014), and cervical metastases (P < .001). Extent of mandibular resection, tumor extension beyond the lower gingiva, recent dental extractions in the region of the primary, perineural invasion, and histologic grade did not affect local control or survival, Although lower gingival carcinoma tends to involve the mandible, our findings indicate that tumor size is more important than mandibular invasion in predicting local disease control, Larger tumors that have a greater propensity for local recurrence and poorer survival require a more extensive surgical resection.