保持下颌骨连续性的舌癌口底癌根治术后复发因素的探讨

Evaluation of Recurrent Factors After Radical Operation for Carcinoma of Tongue and Mouth Floor in Keeping Mandibular Continuation

为了提高舌癌口底癌手术疗效，作者对４７例施行保持下颌骨连续性的舌癌口底癌联合根治术的复发因素进行分析。结果显示：术后复发１４例，复发率为２９．８％。局部复发均在原发灶的内侧软组织。９例舌侧缘口底后部癌中有５例复发（５５．６％），而５例舌侧缘前部癌中无１例复发，两者比较有显著性差异（Ｐ＜０．０５）；Ｔ３～４复发率（４８．０％）明显高于Ｔ１～２复发率（９．１％），Ｐ＜０．０１；有同侧颈淋巴结转移者的复发率（５４．５％）高于无颈淋巴结转移者的复发率（２２．２）％，Ｐ＜０．０５。作者认为：对适应证恰当的病例，术后复发与保持下颌骨连续性无关，而与肿瘤原发部位、大小、颈淋巴结转移及切除范围有关。

For increasing the therapeutic efficiency of surgery for carcinoma of tongue and mouth floor,authors carried out a combined radical operation for 47 cases of carcinoma of tongue and mouth floor in keeping mandibular continuation,the recurrent factors were analyzed.The results showed:14 cases relapsed after operation with a recurrence rate of 29.8%.The local recurrences all were in the inside soft tissues of the original focus.Of 9 cases of carcinoma of posterior part of the tongue′s lateral edge and mouth floor,5 relapsed (55.6%).In 5 cases of carcinoma of the anterior lateral edge of the tongue,none of them relapsed.There was significant difference between both ( P <0.05).The recurrence rate of T 3～4 (48.0%) was significantly higher than that of T 1～2 (9.1%) P <0.01.The recurrence rate of patients with same side cervical metastasis of lymph nodes (54.5%) was higher than that (22.2%) of patients without cervical metastasis ( P <0.05).The authors believe that there is no relationship between postoperative recurrence and keeping mandibular continuation if the indication is appropriate,but it is related to the location of the original tumour,size,whether or not metastasizing to the cervical lymph node and the extent of resection.