Oral oncology最新文献

英文中文

Gemcitabine plus cisplatin versus docetaxel plus cisplatin and fluorouracil induction chemotherapy combined with locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma: A single center prospective phase II clinical trial 吉西他滨加顺铂与多西他赛加顺铂和氟尿嘧啶诱导化疗联合局部放疗治疗新发转移性鼻咽癌：一项单中心前瞻性 II 期临床试验。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-11-03 DOI: 10.1016/j.oraloncology.2024.107087

Kai Shang , Taotao Li , Yue Chen , Xunyan Luo , Huajing Wu , Yu Zhou , Jiayu Song , Weili Wu , Yuanyuan Li , Xiuling Luo , Xiaoxiao Chen , Xiuyun Gong , Chaofen Zhao , Zhuoling Li , Lina Liu , Qianyong He , Jinhua Long , Feng Jin

Purpose

This prospective clinical trial aims to compare the efficacy and safety of gemcitabine plus cisplatin (GP) versus docetaxel plus cisplatin and fluorouracil (TPF) as induction chemotherapy combined with locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma (dmNPC).

Methods

146 dmNPC patients were randomly assigned in a 1:1 ratio to receive 4–6 cycles of GP (GP group) or TPF induction chemotherapy (TPF group) followed by locoregional radiotherapy (LRRT). The primary endpoint was overall survival (OS). Secondary endpoints consisted of progression-free survival（PFS）, objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (AEs).

Results

As of data cutoff (May 31, 2024), the median follow-up time was 60.0 months (IQR 40.3–68.1). There is no significant difference in median OS (35.4 vs. 34.8 months, p = 0.2609) and PFS (15.8 vs. 14.3 months, p = 0.2318) between the GP and TPF groups. No significant differences in ORR (65.8 % vs. 71.2 %, p = 0.476) and DCR (79.5 % vs. 82.2 %, p = 0.674) were observed between GP and TPF group too. Furthermore, the 5-year OS was 40.1 % (95 % CI, 29.6 %-54.2 %) in the GP group, compared with 27.2 % (95 % CI, 17.9 %−41.3 %) in the TPF group（HR = 0.79, 95 % CI, 0.53–1.20). However, the TPF group had higher incidences of grade 3–4 AEs such as neutropenia, leukopenia, nausea, and diarrhea.

Conclusion

The study indicates that 4–6 cycles of TPF induction chemotherapy combined with LRRT achieves a therapeutic effect comparable to the GP regimen with controllable safety.

目的：这项前瞻性临床试验旨在比较吉西他滨加顺铂（GP）与多西他赛加顺铂和氟尿嘧啶（TPF）作为新发转移性鼻咽癌（dmNPC）诱导化疗联合局部放疗的疗效和安全性。方法：146 例 dmNPC 患者按 1:1 的比例随机分配接受 4-6 个周期的 GP 诱导化疗（GP 组）或 TPF 诱导化疗（TPF 组），然后接受局部放射治疗（LRRT）。主要终点是总生存期（OS）。次要终点包括无进展生存期（PFS）、客观反应率（ORR）、疾病控制率（DCR）和治疗相关不良事件（AEs）：截至数据截止日（2024年5月31日），中位随访时间为60.0个月（IQR 40.3-68.1）。GP 组和 TPF 组的中位 OS（35.4 个月 vs. 34.8 个月，p = 0.2609）和 PFS（15.8 个月 vs. 14.3 个月，p = 0.2318）无明显差异。GP 组和 TPF 组的 ORR（65.8% 对 71.2%，p = 0.476）和 DCR（79.5% 对 82.2%，p = 0.674）也无明显差异。此外，GP组的5年OS为40.1%（95 % CI，29.6%-54.2%），而TPF组为27.2%（95 % CI，17.9%-41.3%）（HR = 0.79，95 % CI，0.53-1.20）。然而，TPF组的中性粒细胞减少、白细胞减少、恶心和腹泻等3-4级AE发生率较高：研究表明，4-6个周期的TPF诱导化疗联合LRRT可达到与GP方案相当的疗效，且安全性可控。

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引用次数: 0

Margin-to-depth ratio as an independent prognostic factor in resected oral cavity squamous cell carcinoma: A nationwide cohort study 切除口腔鳞状细胞癌的边缘深度比作为独立预后因素：一项全国性队列研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-11-02 DOI: 10.1016/j.oraloncology.2024.107102

Hanpon Klibngern , Chung-Jan Kang , Li-Yu Lee , Shu-Hang Ng , Chien-Yu Lin , Kang-Hsing Fan , Wen-Cheng Chen , Jin-Ching Lin , Yao-Te Tsai , Shu-Ru Lee , Chih-Yen Chien , Chun-Hung Hua , Cheng-Ping Wang , Tsung-Ming Chen , Shyuang-Der Terng , Chi-Ying Tsai , Hung-Ming Wang , Chia-Hsun Hsieh , Chih-Hua Yeh , Chih-Hung Lin , Chun-Ta Liao

Background

The prognostic significance of margin-to-depth ratio (MDR) in oral cavity squamous cell carcinoma (OCSCC) remains unclear, particularly in comparison to traditional margin status. We aimed to examine the association between MDR and clinical outcomes in a large Taiwanese cohort.

Methods

A total of 18,324 patients with first primary OCSCC were categorized by margin status: positive (1013), <5 mm (8371), and ≥ 5 mm (8940). Disease-specific survival (DSS) and overall survival (OS) served as the main outcome measures.

Results

After excluding patients with positive margins (MDR = 0), the optimal MDR cutoff value for DSS and OS was 0.6. Patients with MDR > 0.6 showed significantly better 5-year DSS and OS rates (87 %, 81 %) compared to those with MDR ≤ 0.6 (71 %, 63 %) and MDR = 0 (53 %, 43 %). Multivariable analysis identified MDR ≤ 0.6 as independently associated with both DSS and OS in the entire cohort (hazard ratio [HR] = 1.34/1.32). This finding was consistent in the subgroups with surgical margins < 5 mm (HR = 1.39 for DSS and 1.38 for OS) and margins ≥ 5 mm (HR = 1.21 for both DSS and OS). In subgroups with surgical margins < 5 mm and ≥ 5 mm, an MDR > 0.6 was associated with better survival outcomes.

Conclusions

An MDR (cutoff: 0.6) is independently associated with prognosis in OCSCC, offering improved risk stratification compared to margin status alone. While MDR may guide surgical margin modification, further research is needed to determine whether MDR could serve as a postoperative indicator for adjuvant therapy in patients with close or clear margins.

背景：口腔鳞状细胞癌（OCSCC）边缘深度比（MDR）的预后意义仍不明确，尤其是与传统的边缘状态相比。我们的目的是在一个大型台湾队列中研究 MDR 与临床预后之间的关系：方法：共对 18,324 例首次原发性 OCSCC 患者按边缘状态进行了分类：阳性（1013 例）、阴性（1013 例）、阳性（1013 例）、阴性（1013 例）和阳性（1013 例）：排除边缘阳性（MDR = 0）患者后，DSS 和 OS 的最佳 MDR 临界值为 0.6。与 MDR ≤ 0.6（71%，63%）和 MDR = 0（53%，43%）的患者相比，MDR > 0.6 的患者的 5 年 DSS 和 OS 率明显更高（87%，81%）。多变量分析发现，在整个队列中，MDR≤0.6与DSS和OS均有独立相关性（危险比[HR] = 1.34/1.32）。这一结果在手术切缘为0.6的亚组中也是一致的，因为0.6与更好的生存结果相关：结论：MDR（临界值：0.6）与OCSCC的预后密切相关，与单纯的边缘状态相比，MDR能更好地进行风险分层。虽然MDR可以指导手术切缘的修改，但还需要进一步研究，以确定MDR是否可以作为切缘紧密或清晰患者术后辅助治疗的指标。

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引用次数: 0

Mitigating biases in feature selection and importance assessments in predictive models using LASSO regression 利用 LASSO 回归减轻预测模型中特征选择和重要性评估的偏差。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-11-01 DOI: 10.1016/j.oraloncology.2024.107090

Yoshiyasu Takefuji

Yuan et al. developed a predictive model for early response using sub-regional radiomic features from multi-sequence MRI alongside clinical factors. However, biases in feature selection and assessment may lead to misleading conclusions regarding feature importance. This paper elucidates the biases induced by machine learning models and advocates for a robust methodology utilizing statistical techniques, such as Chi-squared tests and p-values, to uncover true associations. By emphasizing the vital distinction between true and model-specific associations, we promote a comprehensive approach that integrates multiple modeling techniques. This strategy enhances the reliability of predictive models in medical imaging, ensuring that outcomes are based on objective relationships and ultimately improving patient care.

Yuan等人利用多序列核磁共振成像的亚区域放射学特征和临床因素，建立了一个早期反应预测模型。然而，特征选择和评估中的偏差可能会导致有关特征重要性的误导性结论。本文阐明了机器学习模型所引起的偏差，并主张采用一种稳健的方法，利用统计技术（如卡方检验和 p 值）来发现真正的关联。通过强调真实关联与特定模型关联之间的重要区别，我们提倡一种整合多种建模技术的综合方法。这一策略提高了医学影像预测模型的可靠性，确保结果基于客观关系，最终改善患者护理。

引用次数: 0

Letter to the editor: Burden of oral cancer and associated risk factors at national and state levels: A systematic analysis from the global burden of disease in India, 1990–2021 致编辑的信：国家和邦一级的口腔癌负担及相关风险因素：1990-2021年印度全球疾病负担的系统分析。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-11-01 DOI: 10.1016/j.oraloncology.2024.107093

Himani

引用次数: 0

Comment on: Salivary DNA methylation derived estimates of biological aging, cellular frequency, and protein expression as predictors of oral mucositis severity and survival in head and neck cancer patients 评论唾液 DNA 甲基化衍生的生物老化估计值、细胞频率和蛋白质表达可预测头颈部癌症患者的口腔黏膜炎严重程度和生存期。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-11-01 DOI: 10.1016/j.oraloncology.2024.107097

Diego de Sena Costa de Oliveira, John Lennon Silva Cunha

引用次数: 0

Management of oligometastatic head and neck squamous cell carcinoma: A systematic review 寡转移性头颈部鳞状细胞癌的治疗：系统综述

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-10-31 DOI: 10.1016/j.oraloncology.2024.107085

Jihane Lehyanti , Caroline Even , Etienne Fessart , Cyriaque Wagner-Ballon , Aurélie Moreira , Aline Houessinon

Head and neck squamous cell carcinoma (HNSCC) is the seventh most common type of cancer worldwide. It is mainly discovered in a locally advanced stage, but it is estimated that 40% of recurrences after the treatment of the primary disease will be in a metastatic form, with one third being oligometastatic. There is no clear consensus regarding the treatment of oligometastatic HNSCC, whether it being local treatment, systemic treatment or a combination of both. We put together a systematic review using the Preferred Reporting Item for Systematic review and Meta-Analysis (PRISMA) method to gather all pertinent articles approaching the therapeutic management of oligometastatic HNSCC, especially in the metachronous setting. Out of 344 articles, 21 articles fit our inclusion criteria and were deemed pertinent to help answer the question of our review. Eight studies included only head and neck cancers (HNC) and the other 13 tackled multiple histologies including HNC. Stereotactic body radiotherapy (SBRT) was the treatment of choice for oligometastatic HNSCC with good local control rates and manageable toxicity. Most included studies were retrospective and not randomized. The association of local treatment and systemic treatment was difficult to assess as treatment protocols were not always standardized. There is crucial need for more prospective randomized trials that compare all treatments and sequences as some patients with a high risk of developing polymetastatic disease could derive benefit form a more intensified approach.

头颈部鳞状细胞癌（HNSCC）是全球第七大常见癌症类型。它主要在局部晚期才被发现，但据估计，在治疗原发疾病后，40% 的复发会以转移形式出现，其中三分之一为少转移。关于寡转移性 HNSCC 的治疗，无论是局部治疗、全身治疗还是两者结合，目前还没有明确的共识。我们采用系统综述和荟萃分析首选报告项目（PRISMA）方法进行了一次系统综述，收集了所有关于寡转移 HNSCC 治疗方法的相关文章，尤其是在转移环境中的治疗方法。在 344 篇文章中，有 21 篇符合我们的纳入标准，并被认为有助于回答我们的综述问题。其中八项研究只纳入了头颈部癌症（HNC），另外 13 项研究涉及包括 HNC 在内的多种组织学。立体定向体放射治疗（SBRT）是寡转移性HNSCC的首选治疗方法，具有良好的局部控制率和可控毒性。大多数纳入的研究都是回顾性的，并非随机研究。由于治疗方案并不总是标准化的，因此很难评估局部治疗与全身治疗之间的联系。目前亟需进行更多的前瞻性随机试验，对所有治疗方法和顺序进行比较，因为一些发展为多转移性疾病风险较高的患者可能会从更强化的方法中获益。

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引用次数: 0

Opinion on “Tumor habitat-based MRI features assessing early response in locally advanced nasopharyngeal carcinoma” 关于 "基于肿瘤生境的磁共振成像特征评估局部晚期鼻咽癌的早期反应 "的观点

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-10-31 DOI: 10.1016/j.oraloncology.2024.107095

S. Muthamizh, S. Balachandran, Elangovan Dilipan

引用次数: 0

The value of tongue base mucosectomy in the work-up of squamous cell carcinoma of unknown primary: A Danish national cohort study 舌根粘液切除术在原发灶不明的鳞状细胞癌检查中的价值：一项丹麦全国队列研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-10-30 DOI: 10.1016/j.oraloncology.2024.107083

Signe Bergliot Nielsen , Mikkel Hjordt Holm Larsen , Hani Ibrahim Channir , Katalin Kiss , Benedicte Parm Ulhøi , Christian Godballe , Jesper Grau Eriksen , Niclas Rubek , Thomas Kjaergaard , Christian von Buchwald

Introduction

Squamous cell carcinoma of unknown primary in the head and neck (HNSCCUP) remains a diagnostic challenge. Tongue base mucosectomy by transoral robotic surgery (TORS-TBM) can increase the diagnostic yield and de-intensify treatment. However, the added value of TORS-TBM as an adjunct to work-up programs for HNSCCUP is unclear. Furthermore, the optimal extent of the procedure and selection criteria remain to be established.

Aim

The primary aim of the present study was to assess the diagnostic yield of TORS-TBM as a supplement to a standardized work-up program, using the Danish national guidelines as an example. Secondary aims include predictive values of HPV-testing and PET/CT.

Methods

This was a national multicenter observational cohort study including all patients diagnosed with HNSCCUP from January 2013 to December 2019, who subsequently underwent TORS-TBM. In most cases HPV status was based on dual testing (p16 and HPV-DNA). Predictive values of PET/CT and HPV status were calculated.

Results

A total of 100 consecutive patients underwent TORS-TBM; 93 total TBMs and 7 unilateral TBMs. The primary tumor was detected in 49 % (49/100) of patients. The detection rate was 58 % (47/81) in patients with HPV-associated disease (PPV of HPV status) and 11 % (2/19) in patients with HPV-independent disease. The NPV of HPV status was 89 %. The PPV and NPV of PET/CT was 53 % and 52 %, respectively.

Conclusion

Adding total TORS-TBM to the current Danish guideline-based work-up program on HNCCCUP patients with HPV-associated disease significantly improved the diagnostic yield.

导言：头颈部原发灶不明的鳞状细胞癌（HNSCCUP）仍是诊断难题。通过经口机器人手术（TORS-TBM）进行舌根粘液切除术可提高诊断率并减轻治疗强度。然而，TORS-TBM 作为 HNSCCUP 检查项目的辅助手段，其附加价值尚不明确。目的：本研究的主要目的是以丹麦国家指南为例，评估作为标准化检查项目补充的 TORS-TBM 的诊断率。次要目的包括 HPV 检测和 PET/CT 的预测值：这是一项全国多中心观察性队列研究，包括2013年1月至2019年12月期间诊断为HNSCCUP的所有患者，他们随后都接受了TORS-TBM检查。在大多数情况下，HPV 状态基于双重检测（p16 和 HPV-DNA）。计算了 PET/CT 和 HPV 状态的预测值：共有100名患者连续接受了TORS-TBM手术，其中93例为全侧TBM，7例为单侧TBM。49%的患者（49/100）发现了原发肿瘤。HPV相关疾病患者的检出率为58%（47/81）（HPV状态的PPV），HPV独立疾病患者的检出率为11%（2/19）。HPV状态的NPV为89%。PET/CT 的 PPV 和 NPV 分别为 53% 和 52%：在目前丹麦基于指南的HNCCCUP患者HPV相关疾病检查项目中加入全TORS-TBM，可显著提高诊断率。

{"title":"The value of tongue base mucosectomy in the work-up of squamous cell carcinoma of unknown primary: A Danish national cohort study","authors":"Signe Bergliot Nielsen , Mikkel Hjordt Holm Larsen , Hani Ibrahim Channir , Katalin Kiss , Benedicte Parm Ulhøi , Christian Godballe , Jesper Grau Eriksen , Niclas Rubek , Thomas Kjaergaard , Christian von Buchwald","doi":"10.1016/j.oraloncology.2024.107083","DOIUrl":"10.1016/j.oraloncology.2024.107083","url":null,"abstract":"<div><h3>Introduction</h3><div>Squamous cell carcinoma of unknown primary in the head and neck (HNSCCUP) remains a diagnostic challenge. Tongue base mucosectomy by transoral robotic surgery (TORS-TBM) can increase the diagnostic yield and de-intensify treatment. However, the added value of TORS-TBM as an adjunct to work-up programs for HNSCCUP is unclear. Furthermore, the optimal extent of the procedure and selection criteria remain to be established.</div></div><div><h3>Aim</h3><div>The primary aim of the present study was to assess the diagnostic yield of TORS-TBM as a supplement to a standardized work-up program, using the Danish national guidelines as an example. Secondary aims include predictive values of HPV-testing and PET/CT.</div></div><div><h3>Methods</h3><div>This was a national multicenter observational cohort study including all patients diagnosed with HNSCCUP from January 2013 to December 2019, who subsequently underwent TORS-TBM. In most cases HPV status was based on dual testing (p16 and HPV-DNA). Predictive values of PET/CT and HPV status were calculated.</div></div><div><h3>Results</h3><div>A total of 100 consecutive patients underwent TORS-TBM; 93 total TBMs and 7 unilateral TBMs. The primary tumor was detected in 49 % (49/100) of patients. The detection rate was 58 % (47/81) in patients with HPV-associated disease (PPV of HPV status) and 11 % (2/19) in patients with HPV-independent disease. The NPV of HPV status was 89 %. The PPV and NPV of PET/CT was 53 % and 52 %, respectively.</div></div><div><h3>Conclusion</h3><div>Adding total TORS-TBM to the current Danish guideline-based work-up program on HNCCCUP patients with HPV-associated disease significantly improved the diagnostic yield.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"159 ","pages":"Article 107083"},"PeriodicalIF":4.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognostic impact of intra tumoral HPV-16 viral load in oropharyngeal squamous cell carcinomas 肿瘤内 HPV-16 病毒载量对口咽鳞状细胞癌预后的影响。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-10-28 DOI: 10.1016/j.oraloncology.2024.107082

Agathe Villarmé , Nathalie Ebran , Tanguy Pace-Loscos , Renaud Schiappa , Audrey Mignot , Alexandre Bozec , Anne Sudaka-Bahadoran , Esma Saada-Bouzid , Dorian Culié

Objectives

The incidence of HPV-induced oropharyngeal squamous cell carcinoma (OSCC) is constantly increasing. Although HPV-related OSCC carry a better prognosis, the majority of patients with an HPV-positive OSCC have other prognostic factors such as tobacco smoking, making therapeutic de-escalating approaches less precise. In this context, our study aims to evaluate the prognostic impact of intra-tumoral HPV-16 viral load (VL) in OSCC.

Material and methods

We conducted a retrospective analysis of p16-positive OSCC samples from patients treated between 2012 and 2019. Viral load (VL) was determined using digital droplet Polymerase Chain Reaction (ddPCR) and described according to 3 subgroups: low (<0.9 copies/cell), medium (0.9–85 copies/cell), and high (>85 copies/cell). We assessed the correlation between VL and recurrence-free survival (RFS), specific survival (SS), and overall survival (OS) using the Kaplan-Meier method.

Results

In total, 192 patients were included; 148 (77 %) were male. The mean age was 65. HPV-16 was detected in 189/192 samples (98 %). T3-4-stage (p = 0.002), metastasis (p = 0.007), and tobacco consumption (p = 0.01) predicted lower OS. High VL was associated with higher RFS (HR = 0.2, p = 0.01), SS (HR = 0.32, p = 0.02), and OS (HR = 0.39, p = 0.03). After adjusting for tobacco consumption and tumor stage, high VL remained associated with higher RFS (HR = 0.1, 95 %CI [0.04–0.7], p = 0.01) and SS (HR = 0.20, 95 %CI [0.05–0.75], p = 0.01).

Conclusion

In our study, high intra-tumoral HPV VL was independently associated with survival. Subject to further validation in independent and prospective cohorts, our findings suggest that HPV VL could help to refine the prognosis of HPV positive OSCC patients.

目的：HPV引起的口咽鳞状细胞癌（OSCC）的发病率在不断上升。虽然HPV相关OSCC的预后较好，但大多数HPV阳性OSCC患者都有吸烟等其他预后因素，这使得治疗降级方法不那么精确。在这种情况下，我们的研究旨在评估肿瘤内 HPV-16 病毒载量（VL）对 OSCC 预后的影响：我们对2012年至2019年间接受治疗的p16阳性OSCC患者样本进行了回顾性分析。病毒载量（VL）通过数字液滴聚合酶链式反应（ddPCR）测定，并按照3个亚组进行描述：低（85拷贝/细胞）、高（1.5拷贝/细胞）、中（1.5拷贝/细胞）和高（1.5拷贝/细胞）。我们采用 Kaplan-Meier 法评估了 VL 与无复发生存率（RFS）、特异性生存率（SS）和总生存率（OS）之间的相关性：共纳入 192 例患者，其中男性 148 例（77%），平均年龄 65 岁。平均年龄为 65 岁。在 189/192 份样本中检测到 HPV-16（98%）。T3-4阶段（p = 0.002）、转移（p = 0.007）和吸烟（p = 0.01）预示着较低的OS。高VL与较高的RFS（HR = 0.2，p = 0.01）、SS（HR = 0.32，p = 0.02）和OS（HR = 0.39，p = 0.03）相关。调整烟草消费和肿瘤分期后，高VL仍与较高的RFS（HR = 0.1，95 %CI [0.04-0.7]，p = 0.01）和SS（HR = 0.20，95 %CI [0.05-0.75]，p = 0.01）相关：结论：在我们的研究中，瘤内高HPV VL与生存率密切相关。我们的研究结果表明，HPV VL有助于完善HPV阳性OSCC患者的预后，但还需在独立的前瞻性队列中进一步验证。

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引用次数: 0

Impact of tumor localization and choice of microvascular flap on posterior airway changes following ablative surgery in primary oral squamous cell carcinoma: A monocentric cross-sectional study 原发性口腔鳞状细胞癌消融手术后肿瘤定位和微血管瓣选择对后气道变化的影响：单中心横断面研究

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2024-10-26 DOI: 10.1016/j.oraloncology.2024.107080

Lucas M. Ritschl , Valeriya Sackerer , Katharina Pippich , Jakob K. Zink , Hannes Singer , Alex Grabenhorst , Dennis M. Hedderich , Markus H. Wirth , Klaus-Dietrich Wolff , Andreas M. Fichter , Alexandra V. Behr

Background

The aim of this study was to determine the influence of intraoral reconstructions following oral squamous cell carcinoma (OSCC) resection with a free microvascular flap on the posterior airway space (PAS) and to correlate these results with the potential risk of developing an obstructive sleep apnea syndrome (OSAS).

Materials and methods

Only primary OSCC cases of the tongue or floor of the mouth which were operated and reconstructed. The PAS displayed in computed tomography (CT) scans at three time points were analyzed: t₀ = preoperative, t₁ = first postoperative CT, and t₂ = most recent situation. The following three PAS parameters were calculated: minimum cross-sectional area (minCSA), mean cross-sectional area (meanCSA), and volume.

Results

MinCSA increased from t₀ to t₂: t₀ = 86.9 cm² (0.0 – 251.8), t₁ = 106.6 cm² (1.0 – 483.4), and t₂ = 124.8 cm² (0.5 – 395.6). MeanCSA increased from t₀ to t₂: t₀ = 225.1 cm² (79.0 – 500.2), t₁ = 247.8 cm² (102.8 – 674.3), and t₂ = 272.2 cm² (92.2 – 668.4). The volume increased from t₀ to t₂: t₀ = 21.5 cm³ (8.0 – 63.2), t₁ = 24.1 cm³ (9.6 – 67.3), and t₂ = 26.9 cm³ (6.2 – 67.4).

Conclusions

Posterior airway space PAS values became higher than preoperatively. In particular, flap type had a significant influence on the three PAS parameters.

背景本研究旨在确定口腔鳞状细胞癌（OSCC）切除术后使用游离微血管瓣进行口内重建对后气道间隙（PAS）的影响，并将这些结果与患阻塞性睡眠呼吸暂停综合征（OSAS）的潜在风险联系起来。分析了三个时间点的计算机断层扫描（CT）显示的 PAS：t0 = 术前，t1 = 术后第一次 CT，t2 = 最近一次。结果最小横截面积从 t0 增加到 t2：t0 = 86.9 平方厘米（0.0 - 251.8），t1 = 106.6 平方厘米（1.0 - 483.4），t2 = 124.8 平方厘米（0.5 - 395.6）。平均 CSA 从 t0 增加到 t2：t0 = 225.1 平方厘米（79.0 - 500.2），t1 = 247.8 平方厘米（102.8 - 674.3），t2 = 272.2 平方厘米（92.2 - 668.4）。体积从 t0 增加到 t2：t0 = 21.5 cm3（8.0 - 63.2），t1 = 24.1 cm3（9.6 - 67.3），t2 = 26.9 cm3（6.2 - 67.4）。特别是，皮瓣类型对三个 PAS 参数有显著影响。

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