330例口腔颌面部恶性肿瘤的回顾性分析

Retrospective analysis of 330 cases of oral and maxillofacial malignant tumors

目的回顾性分析口腔颌面恶性肿瘤的治疗效果及预后影响因素。方法回顾性分析2013~2015年在本科收治的上海市籍口腔颌面恶性肿瘤患者330例,其性别、年龄、病变部位、临床分期、病理等因素与临床疗效的关系。结果 330例患者全组中位随访67.3月,1年、3年、5年生存率分别为88.4%、66.4%、59.9%。随访中发现疾病进展的132例患者中,原发灶局部复发及颈部淋巴结转移92例,远处转移40例。年龄<60岁、早期(Ⅰ/Ⅱ期)或初治、病理类型为非鳞癌及无淋巴结转移的患者预后相对较好。淋巴结转移患者,转移个数及包膜外侵犯影响远期生存率。原发涎腺恶性肿瘤的预后优于口腔、口咽部恶性肿瘤。年龄、分期、是否复发是影响预后的独立因素(P<0.05)。结论口腔颌面部恶性肿瘤治疗失败的主要原因为局部及区域复发。年龄、分期及是否复发是影响预后的独立因素,早发现、早诊断、早治疗对提高患者的生存率有重要的意义。

Objective To retrospectively analyze the treatment effect and prognostic factors of oral and maxillofacial malignant tumors. Methods From 2013 to 2015, 330 cases of Shanghai oral and maxillofacial malignant tumor patients in our department were treated. The relationship between the clinical curative effect and the relative factors, such as age, gender, lesion site, clinical stage,pathology, was analyzed retrospectively. Results After a median follow-up of 67.3 months, 1 year, 3-year, 5-year survival rate of 330 cases were 88.4%, 66.4%, 59.9%. There were 132 patients with the disease progression, local recurrence and cervical lymph node metastasis(LNM) in 92 cases, and distant metastasis in 40 cases. The prognosis of patients aged <60 years old, early(Ⅰ/Ⅱ stage) or primary treatment, the pathological type of non-squamous cell carcinoma and no LNM were relatively good. For patients with LNM, the number of LNM and extracapsular node spread had effect on the survival rate. The prognosis of primary salivary gland malignant tumor was superior to oral and oropharyngeal malignant tumors. Age, staging and recurrence or not were the independent factors for the prognosis. Conclusions The main reason for the failure of oral maxillofacial malignant tumor was local and regional recurrence. Age,stage and recurrence or not were independent prognostic factors. Early detection, early diagnosis and early treatment were important for improving the survival of patients.