267例舌癌术后相关因素分析

ANALYSIS OF RELATIVE FACTOR'S FOR 267 CASES OF SQUAMOUS CARCINOMA OF THE TONGUE

目的 探讨和分析影响舌癌术后生成率的相关因素。方法 对在 1988- 0 4～ 1995 - 12间住院的 2 6 7例舌鳞癌术后病例作 3至 8年的随访 ,然后对记录进行分析。其中男 138例 ,女 12 9例 ,年龄 2 8～ 76岁 (平均 5 4.6岁 ) ; - 期患者有 175例 (6 5 .6 % ) ,舌根癌患者 32例 (11.1% ) ;10 7例患者行单纯舌切除 ,16 0例患者行下颌骨部分切除 ,2 0 5例患者行皮瓣修复。结果 (1)男性生存率较女性低 ;(2 )舌体癌 3、5、8年生存率明显高于舌根癌 ;(3)原发灶大小与舌癌预后明显相关 ;(4)淋巴结转移者预后明显差于未转移者 ;(5 )舌癌患者的下颌骨切除与否与预后无明显差别 ;(6 )舌癌原发灶切除即刻行皮瓣修复者与不行皮瓣修复者其生存率无明显差异 ,但可增加手术安全缘、减少复发。结论 不论舌癌患者的淋巴结是否转移 ,施行颈淋巴清扫是十分必要的 ;为提高舌癌患者的生存率 ,应早期发现、早期诊断、早期治疗、定期随访。为了提高患者的生命质量 。

Objective To explore and analyse the relative factor's of postoperation for the tongue cancer. Methods Through follow up 267 cases of squamous carcinoma of the tongue who had been surgery between April 1988 to Dec 1995, (mean follow up from 3 to 8 years) Then we analyse these patients record. there 138 men and 129 women whose age ranged from 28 to 76 years with average 54.6. There were 175 patients who had been staged from Ⅲ to Ⅳ (59.9%) and 32 patients of the base of tongue (11.1%). There were 107 patients who had been resected with tongue only and 160 patients who had been resected with tongue with segmental submaxilla and 205 patients who had been restored with flaps. Results (1) Survival rate of the male patients is lower than famale's. (2) Survival rate for carcinoma of the body of tongue after operated 3 to 8 year is higher than that of the base of tongue. (3) The size of the primary lesion is relavant to prognosis of the tongue cancer. (4) The prognosis of patients whose node metastasis was positive is great lower than that whose node metastasis was negative. (5) There was no significant difference in survial rate between carcinoma patients with excision of mandible of mandible and that without excision of mandible. (6) When the tongue was restored with flaps, it was helpful to increase the safety margin, reduce recurence of disease. Conclusion Whatever the nodes of the patients with tongue cancer metastasized or not, radical neck dissection We suggest that early finding, diagnose, treatment and regular follow up be essential to raise survival rate. At the same, it muse be as possible as to preserve the mandible and to repair the tongue with flaps in order to raise patients quality of life.