60例唇鳞癌患者手术治疗效果和复发因素分析

Analysis of surgical treatment effect and recurrence factors in 60 patients with lip squamous cell carcinoma

目的 探讨唇鳞状细胞癌(LSCC)患者接受手术治疗的效果和影响其临床复发的因素。方法 回顾性分析2012年1月至2018年12月诊治的60例唇鳞癌患者的资料,从预后、淋巴转移、复发等方面评估患者接受手术治疗的效果。采用Kaplan-Meier法和log-rank检验进行生存分析,采用χ2检验分析影响患者临床复发的因素。应用SPSS 22.0软件包对数据进行统计分析,P <0.05为差异有统计学意义。结果 患者的1年、3年和5年总生存率分别为100%、90%和79.4%,5年疾病特异性生存率为89.9%。共有9例患者死亡,其中4例死于局部复发和颈部转移,1例死于腹部转移。单因素分析显示,吸烟、pT分期和临床复发是影响患者预后的危险因素(P <0.05)。共有16例患者接受了颈淋巴清扫,3例确诊颈淋巴结转移。术后共复发8例,其中颈淋巴结转移4例,术后复发率和转移率分别为13.3%和6.7%。结论 唇鳞癌患者手术治疗效果较好,T分期较晚和初诊时肿瘤具有较强生物学侵袭表现的患者术后易复发。

Objective To investigate the effect of surgical treatment and the factors influencing clinical recurrence in patients with squamous cell carcinoma of the lip(LSCC). Methods The data of 60 patients with lip squamous cell carcinoma from January 2012 to December 2018 were retrospectively analyzed, and the effect of surgical treatment was evaluated. Kaplan-Meier method and log-rank test were used for survival analysis, and χ2 test was used to analyze the factors of clinical recurrence. Results The 1-year, 3-year and 5-year overall survival rates were 100%, 90% and 79.4%,respectively. The 5-year disease-specific survival rate was 89.9%. A total of 9 patients died, of which 4 died of local recurrence and cervical metastasis, and one died of abdominal metastasis. Univariate analysis showed that smoking, pT staging and clinical recurrence were the risk factors of prognosis(P<0.05). A total of 16 patients underwent neck dissection,and 3 patients were diagnosed with neck lymph node metastasis. There were 8 patients with postoperative recurrence,including 4 patients with neck lymph node metastasis, and the postoperative recurrence rate and metastasis rate were 13.3%and 6.7%, respectively. Conclusions The effect of surgical treatment for patients with squamous cell carcinoma of the lip is good. Patients with late T stage and strong biological invasion at the time of initial diagnosis are easy to relapse after operation.