127例舌鳞状细胞癌患者单纯手术治疗的生存和预后分析

Survival analysis of 127 patients with tongue squamous cell carcinoma barely underwent radical surgery

目的探讨单纯手术治疗影响舌鳞状细胞癌(TSCC)患者预后的临床病理因素。方法选择1996年1月至2007年1月间在中山大学附属第二医院口腔科首治的,经病理确诊且随访资料完整的单纯手术治疗的TSCC患者共127例。应用Kaplan-Meier法分析生存结果,通过Cox回归模型确立影响预后的独立因素。结果127例单纯手术治疗的TSCC患者的平均生存时间为40.19个月,5年生存率为52.0%。单因素分析显示,影响TSCC患者预后的因素包括年龄、肿瘤部位、肿瘤大小、淋巴结转移、肿瘤临床分期和肿瘤复发等。多因素分析得出影响预后的独立因素为肿瘤复发。结论肿瘤复发为TSCC预后的独立影响因子;淋巴结转移阴性TSCC患者单纯手术预后较好,中晚期TSCC伴淋巴结转移阳性患者单纯手术预后差,需进行综合性序列治疗。

Objective The effect of chemotherapy and radiotherapy in the comprehensive treatment for tongue squamous cell carcinoma （TSCC） is still not clear enough. The evaluation of the prognostic significance of clinical parameters with the patients undergo radical surgery is necessary. Methods 127 cases who underwent radical surgery for TSCC only from 1996 January to 2007 January, in the Department of Oral and Maxillaficial Surgery, the Second Affiliated Hospital, Sun Yat-Sen University were collected. The clinical parameters were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier analysis, comparison among groups was analyzed using log-rank test, and multivariate analysis was conducted using the Cox proportional hazard model. Independent risk factors were deducted. Results The mean survival time of the 127 patients was 40.17 months, with five-year survival rates of 52.0%, respectively. Univariate analysis showed that age, part of tongue invasion, cervical lymphatic metastasis, tumor clinical stage, and recurrence were risk factors affecting prognosis （P〈 0.05）. Multivariate analysis indicated that recurrence was the independent factor for prognosis. Conclusions Recurrence is an independent factor affecting the prognosis. The prognosis of patients who underwent radical surgery is similar with those underwent the comprehensive and sequential treatment of the TSCC without lymphatic metastasis. But the prognosis of patients who underwent radical surgery of the TSCC with lymphatic metastasis is poor, and comprehensive and sequential treatment is necessary for this group of cases.