口舌鳞状细胞癌复发因素分析

Analysis of Factors about Recurrence of Oral Tongue Squamous Cell Carcinomas

目的:分析口腔舌鳞癌复发及转移的相关因素。方法:回顾性分析本院初治的210例原发口腔舌鳞状细胞癌病例,对比不同治疗方法的复发率,COX多因素回归模型分析局部复发、区域复发及远处转移的相关临床因素。结果:210例患者5年总生存率为61.1%,总复发率为31.9%,局部复发率为23.8%,区域复发率为16.7%,远处转8移.5率%为。多5.7因%素。分单析纯中手局术部组复、单发纯率放的疗影组响、因术素前为放治疗疗组方、术法后、放T分疗级组,患区者域总复的发局的部影复响发因率素分为别局为部5复.1发%、,4而2.远7%处、1转7.移3%的、影响因素为病理分化程度和区域复发。局部和区域复发分别有92.0%和91.4%治疗后2年出现,复发患者经再治疗后分别有24%和34.3%获得控制。结论:局部和区域控制是舌癌治疗的关键,早期舌癌可选择单纯手术,晚期舌癌应选择综合治疗,治疗后应密切随访至少2年,对复发病例进行及时治疗仍有部分患者可获得良好的局部及区域控制。

Objective： To analyze the prognostic factors about recurrence of oral tongue squamous cell carcinomas. Methods： A total of 210 cases of oral tongue cancer were retrospectively reviewed. The recurrence rates of different methods were compared and the factors that influenced local, regional and distant control were identified with Cox regression. Results： The 5-year overall survival rate of these 210 patients was 61.1%. The overall recurrence rate was 31.9%. The local recurrence rate was 23.8% and the regional recurrence rate was 16.7%. The rate of distant metastasis was 5.7%. The local recurrence rate was 5.1% in the group treated with surgery alone, 42.7 in the group treated with radiotherapy alone, and 17.3% in the group treated with preoper- ative radiotherapy and surgery, and 8.5% in the group treated with postoperative radiotherapy and surgery. In Cox regression, treatment modalities and T stages had significant influence on local control. Good regional control could be achieved without local recurrence. Regional recurrence and poor pathological differentiation would lead to high distant metastasis rate. At 2 years after treatment, the local recurrence rate was 92% and the regional recurrence rate was 91.4%. Conclusion： To achieve good local and regional control, surgery alone for oral tongue cancers of early stage and combined treatment modalities for advanced diseases were recommended, respectively. A follow-up of at least 2 years after treatment is necessary. Salvage treatment for some patients with recurrence can achieve good local and regional control.