Oral oncology最新文献_第7页

Refining surveillance in surgically treated HPV(+)OPSCC: The path to Risk-Adapted strategies 改进手术治疗的HPV(+)OPSCC的监测：风险适应策略的路径。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI: 10.1016/j.oraloncology.2025.107812

Jiaqian Wu, Jianning Zhang, Jiachuan Lin, Yan Huo

引用次数: 0

Blinded comparative evaluation of GPT-generated, online search-derived, and guideline-based answers for HPV-associated oropharyngeal cancer gpt生成的、在线搜索衍生的和基于指南的hpv相关口咽癌答案的盲法比较评价

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1016/j.oraloncology.2025.107813

Sholem Hack , Rebecca Attal , Karin Geva , Armin Farzad , Shibli Alsleibi , Naseem Saleh , Ben Gvili , David Yogev , David Shahal , Benyamin Meir Kaminer , Eric Remer

Objective

To compare the quality of online information about human papillomavirus (HPV)–associated oropharyngeal cancer generated by a large language model with content retrieved from conventional web search and authoritative guideline-based sources.

Methods

Twenty high-volume patient search queries were identified using global Google Trends data. For each question, responses were obtained from GPT-4 (OpenAI), the highest-ranked non-sponsored Google Search result, and leading governmental or guideline-based websites. Responses were anonymized and evaluated in a blinded manner by seven otolaryngology specialists and ten adult laypersons. Experts assessed accuracy, clarity, completeness, relevance, and usefulness; laypersons rated clarity, trustworthiness, and usefulness. Comparative analyses were performed using Friedman and Bonferroni-corrected Wilcoxon signed-rank tests, with inter-rater agreement estimated using intraclass correlation coefficients (ICC)

Results

ChatGPT-generated responses received higher mean ratings than Google Search across all domains for both rater cohorts (p < 0.001 for all comparisons). Experts rated GPT-4 and guideline-based content similarly for accuracy, completeness, and usefulness, while GPT-4 scored significantly higher for clarity and relevance (p < 0.01). Laypersons rated GPT-4 responses highest across all domains, with median scores of 5 versus 4 for the other sources. Inter-rater agreement was modest for subjective domains.

Conclusion

ChatGPT-generated information on HPV-associated oropharyngeal cancer matched the accuracy and completeness of authoritative guideline-based content and demonstrated significantly greater clarity and relevance, while outperforming conventional web search results. LLMs may help improve accessibility and consistency of online patient education when implemented with expert oversight, transparent sourcing, and ongoing quality monitoring.

目的比较大型语言模型生成的人乳头瘤病毒（HPV）相关口咽癌在线信息与传统网络搜索和权威指南来源检索的内容的质量。方法使用全球谷歌Trends数据确定20个大容量患者搜索查询。对于每个问题，答案都来自GPT-4 (OpenAI)，排名最高的非赞助谷歌搜索结果，以及领先的政府或基于指南的网站。7名耳鼻喉科专家和10名成人外行对回答进行匿名和盲法评估。专家评估了准确性、清晰度、完整性、相关性和有用性；外行人对清晰度、可信度和实用性进行了评价。使用Friedman和bonferroni校正的Wilcoxon符号秩检验进行比较分析，使用类内相关系数（ICC）估计评分者之间的一致性。结果，在两个评分者队列的所有域中，schatgpt生成的回答获得的平均评分高于谷歌搜索（所有比较的p <； 0.001）。专家对GPT-4和基于指南的内容在准确性、完整性和有用性方面的评价相似，而GPT-4在清晰度和相关性方面的得分明显更高（p < 0.01）。外行人对GPT-4的评分在所有领域中最高，中位数为5分，而其他来源为4分。评分者之间在主观领域的一致性不高。结论chatgpt生成的hpv相关口咽癌信息的准确性和完整性与权威指南内容相匹配，并且显示出更大的清晰度和相关性，同时优于传统的网络搜索结果。法学硕士可以帮助提高在线患者教育的可访问性和一致性，如果实施专家监督，透明的采购和持续的质量监控。

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引用次数: 0

Is 55 years an optimal age cutoff point for clinical staging in T1 papillary thyroid cancer? 55岁是T1型甲状腺乳头状癌临床分期的最佳年龄分界点吗？

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.oraloncology.2025.107817

Daixing Hu , Zhuolin Dai , Yang Feng , Xinliang Su , Chun Huang

Background

This study aims to determine the optimal age cutoff for T1 papillary thyroid cancer (PTC), with a particular focus on the T1a and T1b subgroups.

Methods

A retrospective review of electronic medical records was conducted to identify patients who underwent thyroidectomy at our institution from January 2013 to December 2018.

Results

The study cohort consisted of 2,862 patients, including 765 men (26.7 %) and 2,097 women (73.3 %). Survival analysis demonstrated significantly poorer recurrence-free survival (RFS) in patients aged ≥55 years (p < 0.001). Patients were stratified into T1 (tumor size ≤2 cm, n = 2,328) and non-T1 (tumor size >2 cm, n = 534) subgroups. Among the non-T1 subgroup, older patients exhibited significantly inferior RFS, consistent with the overall cohort (p < 0.001). However, this difference was not observed in the T1 subgroup (p = 0.079). Within the T1 PTC subgroup, significant differences were identified between T1a and T1b patients concerning gender distribution, tumor size, clinical lymph node-positive status (cN1), total thyroidectomy, bilaterality, presence of Hashimoto’s thyroiditis, central lymph node metastasis, lateral lymph node metastasis, and radioiodine treatment (all p < 0.05). Further analysis indicated that when stratified by an age cutoff of 65 years, the prognosis for T1b patients was statistically significant (p = 0.018), whereas the prognosis for T1a patients was not statistically significant (p = 0.64).

Conclusion

The clinicopathologic characteristics of T1b patients differ significantly from those of T1a patients. Age may not be a critical factor in the prognostic staging system for T1a PTC patients, whereas 65 years appears to be a more appropriate age cutoff for T1b patients.

本研究旨在确定T1乳头状甲状腺癌（PTC）的最佳年龄界限，特别关注T1a和T1b亚组。方法回顾性分析2013年1月至2018年12月在我院行甲状腺切除术患者的电子病历。结果研究队列包括2862例患者，其中男性765例（26.7%），女性2097例（73.3%）。生存分析显示，年龄≥55岁的患者无复发生存率（RFS）明显较差（p < 0.001）。将患者分为T1组（肿瘤大小≤2 cm， n = 2328）和非T1组（肿瘤大小≤2 cm， n = 534）。在非t1亚组中，老年患者表现出明显较差的RFS，与整个队列一致（p < 0.001）。然而，在T1亚组中没有观察到这种差异（p = 0.079）。在T1 PTC亚组中，T1a和T1b患者在性别分布、肿瘤大小、临床淋巴结阳性状态（cN1）、全甲状腺切除术、双侧、是否存在桥本甲状腺炎、中央淋巴结转移、侧淋巴结转移和放射性碘治疗方面存在显著差异（p < 0.05）。进一步分析发现，以65岁分层时，T1b患者的预后有统计学意义（p = 0.018），而T1a患者的预后无统计学意义（p = 0.64）。结论T1b患者的临床病理特征与T1a患者有显著差异。年龄可能不是T1a PTC患者预后分期系统的关键因素，而65岁似乎是T1b患者更合适的年龄界限。

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引用次数: 0

Cerebrovascular events after head and neck radiation therapy: A systematic review and Meta-Analysis 头颈部放射治疗后脑血管事件：系统回顾和荟萃分析。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-13 DOI: 10.1016/j.oraloncology.2025.107810

Kennedy Ayoo , Elliot Koo , Noémie Villemure-Poliquin , Rui Fu , Jonathan C Irish , Thomas Lindsay , Antoine Eskander

Background

Several studies have demonstrated increased risk of cerebrovascular events, including carotid stenosis, stroke & transient ischemic attack, following head and neck radiation therapy (RT) for head and neck cancer (HNC). This systematic review reports the incidence of cerebrovascular events (CVEs) and the relative rate (RR) of ischemic stroke in patients treated with RT compared to non-RT populations.

Methods

A comprehensive database search identified publications reporting the incidence or RR of CVEs following RT. Citations were retrieved, and data was extracted where appropriate. Risk of bias was assessed, and meta-analyses were conducted to present pooled estimates of the incidence of CVEs after RT and the RR of ischemic stroke.

Results

2,598 citations were retrieved, of which 50 met criteria for inclusion. The incidence of carotid stenosis ranged from 0 %-40 % over median follow-up duration of 6–68 months (mean = 6–150 months). The incidence of ischemic stroke was 8.98 per 1,000 person-years (95 % CI: 4.66 – 17.30). The relative rate of ischemic stroke was higher in patients treated with radiation therapy with a HR of 1.33 (95 % CI: 1.21 – 1.45) when compared to a reference population (HR of 1) of those treated with surgery and a HR of 1.29 (95 % CI: 1.13 – 1.47) when compared to the general population as the reference group.

Conclusions

HNC patients face an increased risk of ischemic stroke following head and neck radiation therapy. The magnitude of this heightened risk remains elusive in the contemporary era of intensity-modulated radiation techniques and should be addressed in future studies.

背景：一些研究表明，头颈癌（HNC）放疗后脑血管事件的风险增加，包括颈动脉狭窄、中风和短暂性脑缺血发作。本系统综述报道了与非RT人群相比，接受RT治疗的患者的脑血管事件（CVEs）发生率和缺血性卒中的相对发生率（RR）。方法：通过全面的数据库检索，确定报道rt后cve发生率或RR的出版物。检索引文，并在适当的地方提取数据。对偏倚风险进行了评估，并进行了荟萃分析，以汇总估计RT后cve的发生率和缺血性卒中的RR。结果：共检索到2598篇引文，其中50篇符合纳入标准。在6-68个月的中位随访期间（平均6-150个月），颈动脉狭窄的发生率为0% - 40%。缺血性卒中的发生率为8.98 / 1000人年（95% CI: 4.66 - 17.30）。接受放射治疗的患者缺血性卒中的相对发生率较高，与接受手术治疗的参考人群（HR为1）相比，其HR为1.33 (95% CI: 1.21 - 1.45)，与作为参考组的一般人群相比，其HR为1.29 （95% CI: 1.13 - 1.47）。结论：HNC患者在头颈部放射治疗后面临缺血性卒中的风险增加。在调强辐射技术的当代时代，这种增加的风险的程度仍然难以捉摸，应该在未来的研究中加以解决。

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引用次数: 0

Survival rates and oncologic outcomes of adeno squamous carcinoma of oral cavity: A systematic review 口腔腺鳞癌的生存率和肿瘤预后：一项系统综述。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-13 DOI: 10.1016/j.oraloncology.2025.107821

Francesco Chiari , Andrea Luigi Camillo Carobbio , Marco Ferrari , Piero Nicolai , Claudio Donadio Caporale , Pierre Guarino

Background

Adenosquamous carcinoma (ASC) of the oral cavity is an uncommon and aggressive malignancy characterized by squamous and glandular histologic components. Due to its rarity, clinical behavior and oncologic outcomes remain poorly defined.

Methods

A systematic literature review was conducted according to PRISMA 2020 guidelines. Comprehensive searches of Embase, PubMed, Scopus, and Cochrane Library identified studies published between 1968 and 2025.

Results

Sixty-one patients were included. The most frequent subsites were tongue (43 %) and floor of mouth (31 %). Transoral surgery was performed in 93 % of cases, with neck dissection in 50 %. Adjuvant therapy was administered in 27 %. Despite 57 % presenting with early-stage disease, recurrence occurred in 42 %: local (36 %), regional (20 %), and distant (10 %). Local recurrence was significantly associated with advanced stage (p = 0.007) and subsite (p = 0.028), highest in floor of mouth (59 %) and gingiva (50 %). Perineural invasion (PNI), lymphovascular invasion (LVI), and positive margins correlated with recurrence and reduced time to recurrence (TTR), disease-specific survival (DSS), and overall survival (OS) (p < 0.001). Two-year TTR, DSS, and OS rates were 47 %, 74 %, and 70 %, respectively—lower than reported for conventional oral squamous carcinoma. Because oral ASC is rare, the evidence is primarily derived from case reports and small retrospective series.

Conclusions

Oral ASC demonstrates high recurrence and poor survival, even in early-stage disease. Prognosis is strongly influenced by PNI, LVI, and margin status, as well as tumor subsite. These findings highlight oral ASC as a distinct and particularly aggressive entity.

背景：口腔腺鳞癌（ASC）是一种罕见的侵袭性恶性肿瘤，以鳞状和腺状的组织学成分为特征。由于其罕见性，临床行为和肿瘤预后仍不明确。方法：根据PRISMA 2020指南进行系统文献综述。对Embase、PubMed、Scopus和Cochrane图书馆的综合搜索确定了1968年至2025年间发表的研究。结果：纳入61例患者。最常见的亚部位是舌头（43%）和口腔底部（31%）。经口手术占93%，颈清扫占50%。27%的患者接受辅助治疗。尽管57%的患者表现为早期疾病，但42%的患者出现了复发：局部（36%）、局部（20%）和远处（10%）。局部复发率与晚期（p = 0.007）和亚部位（p = 0.028）有显著相关性，以口腔底（59%）和牙龈（50%）最高。围神经侵袭（PNI）、淋巴血管侵袭（LVI）和阳性切缘与复发、缩短复发时间（TTR）、疾病特异性生存（DSS）和总生存（OS）相关。结论：口服ASC具有高复发率和低生存率，即使在早期疾病中也是如此。PNI、LVI、边缘状态以及肿瘤亚位点对预后有很大影响。这些发现强调口腔ASC是一种独特的、特别具有侵袭性的实体。

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引用次数: 0

Intrathyroid thymic carcinoma diagnosed following an odontogenic infection: Insights from a rare clinical presentation 牙源性感染后诊断的甲状腺内胸腺癌：来自罕见临床表现的见解

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-11-27 DOI: 10.1016/j.oraloncology.2025.107797

Hitoshi Miyashita , Haruka Saito , Masashi Katoh , Fumiyoshi Fujishima , Nobuo Ohta

引用次数: 0

Establishment and characterization of a new immortalized human oral keratinocyte (HOK) cell line harboring various TP53 mutations 一种新的携带多种TP53突变的永生化人口腔角化细胞（HOK）细胞系的建立和表征

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-11-29 DOI: 10.1016/j.oraloncology.2025.107799

Mei Zhao , Zhiyi Liu , Mutsuki Kawabe , Abdullah A Osman , Mitchell J. Frederick , Jeffrey N Myers

Head and neck squamous cell carcinoma (HNSCC) is characterized by frequent TP53 mutations, which include gain-of-function (GOF) variants that drive tumor progression and chemoresistance. While genomic evidence across multiple specimens ranging from oral pre-malignant lesions (OPL) through invasive and metastatic HNSCC indicates that TP53 loss or mutation occurs relatively early in HNSCC carcinogenesis, it has been difficult to discern how mutation of this tumor suppressor drives further tumor cell evolution and influences the tumor microenvironment to drive tumor progression. To address this question, we generated an immortalized human oral keratinocyte (iHOK) cell line expressing wt TP53 as well as TP53 mutant forms to determine how mutations impact functional and genomic characteristics of HOKs that can in turn drive their evolution to neoplastic cells.

We established a novel panel of iHOK cell lines harboring distinct TP53 mutations, including the high-risk C238F variant. Key results revealed significant phenotypic and molecular divergence: high-risk lines exhibited enhanced invasiveness and chemoresistance compared to low-risk counterparts. Weighted gene co-expression network analysis (WGCNA) linked high-risk mutations to pro-metastatic pathways and stress-response signatures, with the C238F line uniquely enriched for p53-related GOF mechanisms. Conversely, low-risk lines remained chemosensitive.

These findings underscore the clinical relevance of mutation-specific iHOK models in determining the transcriptomic events that drive invasiveness and drug resistance and identify ways to intercept these phenotypes. By mirroring the TP53 diversity observed in patient tumors, this cell line panel bridges a critical gap in head and neck carcinogenesis research, enabling mechanistic dissection of GOF phenotypes and preclinical evaluation of therapies in an array of TP53 mutant cell models. Its significance lies in providing a validated, annotated resource that accelerates drug discovery and clarifies the role of TP53 mutational subtypes in HNSCC development and progression, offering a framework for future translational studies in genetically complex malignancies.

头颈部鳞状细胞癌（HNSCC）的特征是TP53频繁突变，其中包括驱动肿瘤进展和化疗耐药的功能获得（GOF）变异。虽然从口腔癌前病变（OPL）到侵袭性和转移性HNSCC的多个标本的基因组证据表明，TP53的缺失或突变在HNSCC癌变中发生得相对较早，但很难确定这种肿瘤抑制因子的突变如何进一步驱动肿瘤细胞进化并影响肿瘤微环境以驱动肿瘤进展。为了解决这个问题，我们产生了一个永生化的人类口腔角质细胞（iHOK）细胞系，表达TP53和TP53突变形式，以确定突变如何影响hok的功能和基因组特征，进而推动它们向肿瘤细胞的进化。我们建立了一个新的iHOK细胞系小组，其中包含不同的TP53突变，包括高风险的C238F变体。关键结果揭示了显著的表型和分子差异：与低风险的同类品种相比，高风险品系表现出增强的侵袭性和化学耐药。加权基因共表达网络分析（WGCNA）将高风险突变与促转移途径和应激反应特征联系起来，C238F系独特地富集了p53相关的GOF机制。相反，低风险系仍然对化学药物敏感。这些发现强调了突变特异性iHOK模型在确定驱动侵袭性和耐药性的转录组事件以及确定拦截这些表型的方法方面的临床相关性。通过反映患者肿瘤中观察到的TP53多样性，该细胞系面板弥补了头颈癌发生研究的关键空白，能够对GOF表型进行机制解剖，并在一系列TP53突变细胞模型中对治疗进行临床前评估。它的意义在于提供了一个经过验证的、有注释的资源，加速了药物的发现，阐明了TP53突变亚型在HNSCC发生和进展中的作用，为未来在遗传复杂恶性肿瘤中的转化研究提供了一个框架。

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引用次数: 0

Treatment and outcome for 2,111 patients with vermilion lip squamous cell carcinoma: A nationwide, population-based study from the SweHNCR 2111例红唇鳞状细胞癌患者的治疗和结果：一项来自SweHNCR的全国性、基于人群的研究

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.oraloncology.2025.107818

A. Hafström , E. Hammerlid , M. Beran , M. Olin , A. Högmo , L. Farnebo

Background and importance

The major risk factor for vermilion lip squamous cell carcinoma (vlSCC) is excessive sunlight exposure. Population-based studies on treatment and outcome are lacking.

Methods

This is a nation-wide, population-based study of treatment and outcome from prospectively recorded data for 2,111 vlSCC registered in the Swedish Head and Neck Cancer Register (SweHNCR) diagnosed 2008–2022.

Results

The age standardized incidence increased with 34 % between 2008 and 2022, from 1.14 to 1.53 per 100,000 (19 % for males and 55 % for females). Median age at diagnosis was 76 years and 72.4 % had good performance status. Males predominated (57.1 %). Lower lip vlSCC comprised 82.6 % and upper 8.6 %. Most had T1 (81.7 %) or T2 (13.5 %) tumors and few had regional (2.7 %) or distant (0.1 %) metastases. The 5-year observed overall survival was 70.5 % (95 % CI 68.4–72.6) and relative survival 90.8 % (95 % CI 88.2–93.7).

Treatment data were registered in 1,948 cases and 97.5 % (1,900) had a curative intent, whereof 88.5 % had surgery, 7.3 % radiotherapy, and 4.2 % combination treatment. Recurrences were registered in 5.6 % (48.6 % local, 42.1 % regional) whereof 15.9 % after three years. Stage I recurred after median 17 (IQR 9–28) months whereas stage II and III after 10 months (7–17 and 9–13, respectively). Advanced age (p < 0.001), poor performance status (p < 0.001), male sex (p = 0.002), high stage (p = 0.041), and only radiotherapy (p = 0.007) remained as independent prognostic factors for mortality.

Conclusion

Females had higher incidence increase than males. Advanced age, poor performance status, male sex, advanced disease, and radiotherapy only were independent prognostic factors for mortality.

背景和重要性朱红色唇鳞状细胞癌（vlSCC）的主要危险因素是过度的阳光照射。目前缺乏以人群为基础的治疗和结果研究。方法：这是一项全国性的、基于人群的研究，对2008-2022年在瑞典头颈癌登记处（SweHNCR）诊断的2111例vlSCC的治疗和结果进行前瞻性记录。结果2008年至2022年，年龄标准化发病率从1.14 / 10万增加到1.53 / 10万，增加了34%（男性19%，女性55%）。诊断时的中位年龄为76岁，72.4%的患者表现良好。男性占多数（57.1%）。下唇vlSCC占82.6%，上唇占8.6%。大多数为T1（81.7%）或T2（13.5%）肿瘤，少数为局部（2.7%）或远处（0.1%）转移。5年观察总生存率为70.5% (95% CI 68.4-72.6)，相对生存率为90.8% （95% CI 88.2-93.7）。登记的治疗资料为1948例，97.5%（1900例）有治愈意图，其中手术治疗占88.5%，放疗占7.3%，联合治疗占4.2%。复发率为5.6%（本地48.6%，区域42.1%），三年后复发率为15.9%。I期复发的中位时间为17个月（IQR为9-28），II期和III期复发的中位时间为10个月（分别为7-17和9-13）。高龄（p < 0.001）、表现不佳（p < 0.001）、男性（p = 0.002）、晚期（p = 0.041）和仅放疗（p = 0.007）仍然是死亡的独立预后因素。结论女性发病率高于男性。高龄、运动状态差、男性、疾病晚期和放疗仅是死亡率的独立预后因素。

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引用次数: 0

Trans-hairline robotic neck dissection and robotic microvascular free flap reconstruction in oral cavity cancer 跨发际线机器人颈部清扫和机器人微血管游离皮瓣重建在口腔癌中的应用。

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-15 DOI: 10.1016/j.oraloncology.2025.107819

Velda Ling-Yu CHOW, Valerie Wai-Yee HO, Arthur Shing-Ho LO

Background

A report on the feasibility of sequential robotic-assisted neck dissection and robotic micro-surgical free flap reconstruction via a trans-hairline approach in oral cavity cancer patients.

Material and methods

A patient with cT2N0 right tongue squamous cell carcinoma is used for illustration.

Results

A trans-hairline incision is used. Subplatysmal flaps are raised and levels I-III cervical lymph nodes are exposed. Da Vinci Xi robotic system is then docked via trans-hairline incision for neck dissection followed by trans-oral hemi-glossectomy. Skin island of free anterolateral thigh flap is used to reconstruct intra-oral mucosal defect. Flap pedicle is passed to the neck medial to mandible for microvascular anastomosis using the Symani micro-robotic surgical system via trans-hairline incision.

Conclusion

Trans-hairline robotic-assisted neck dissection and robotic microvascular free flap surgery is feasible and safe with good cosmetic and functional outcomes in oral cavity cancer patients.

背景：报道了经发际线入路的机器人辅助颈清扫和机器人显微手术游离皮瓣重建在口腔癌患者中的可行性。材料与方法：以1例cT2N0右舌鳞状细胞癌为例。结果：采用跨发际切口。板下瓣抬高，暴露I-III级颈淋巴结。然后通过发际线切口对接Da Vinci Xi机器人系统进行颈部清扫，然后进行经口半舌切除术。应用游离大腿前外侧皮瓣皮肤岛修复口腔黏膜缺损。采用Symani微型机器人手术系统经发际线切口将皮瓣蒂经颈部内侧至下颌骨进行微血管吻合。结论：跨发际线机器人辅助颈部清扫和机器人微血管游离皮瓣手术在口腔癌患者中是可行且安全的，具有良好的美容和功能效果。

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引用次数: 0

Neoadjuvant tislelizumab plus chemotherapy in locally advanced oral and oropharyngeal squamous cell carcinoma: A single-arm phase II clinical trial 新辅助tislelizumab联合化疗治疗局部晚期口腔和口咽鳞状细胞癌：单臂II期临床试验

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1016/j.oraloncology.2025.107809

Wen-Jie Wu , Pu-Gen An , Zi-Qi Zhang , Li-Hang Shen , Jian-Yun Zhang , Yan Chen , Ming-Wei Huang , Shu-Ming Liu , Jie Yao , Jie Zhang

Background

This study aimed to evaluate the antitumor effect and safety of neoadjuvant chemotherapy plus tislelizumab (a programmed death-1 inhibitor) for the treatment of resectable locally advanced oral or oropharyngeal squamous cell carcinoma (LAOOPSCC).

Methods

Eligible patients with stage III-IV LAOOPSCC were treated with two cycles of tislelizumab (200 mg), albumin-bound paclitaxel (260 mg/m²), and cisplatin (60–75 mg/m²) with a three-week interval between each cycle; this treatment was followed by surgery and adjuvant radiotherapy or concurrent chemoradiotherapy. The primary endpoints were the major pathological response (MPR) rate and safety.

Results

Between March 2022 and June 2023, a total of 82 patients were eligible and completed two cycles of neoadjuvant therapy; 78 patients underwent imaging evaluation, and 73 underwent surgery and pathological response evaluation. Forty patients underwent de-escalation surgery for the primary tumor. Orbital floor resection was avoided in 1 patient, mandibulectomy was avoided in 5 patients, and near-total glossectomy or total glossectomy was avoided in 32 patients. An objective response rate of 67.9 % and an MPR rate of 60.3 % were achieved, with 34.2 % of patients achieving a pathological complete response. With a median follow-up time of 24 months, the two-year overall survival rate was 84.4 %, and the two-year event-free survival rate was 76.7 %. Treatment-related adverse events of grade 3 or 4 occurred in 11 patients (13.4 %) during the neoadjuvant therapy.

Conclusions

Neoadjuvant tislelizumab plus chemotherapy for LAOOPSCC achieved a high pathological response rate and favorable survival metrics with an acceptable safety profile.

本研究旨在评估新辅助化疗联合tislelizumab（一种程序性死亡-1抑制剂）治疗可切除的局部晚期口腔或口咽鳞状细胞癌（LAOOPSCC）的抗肿瘤效果和安全性。方法符合条件的III-IV期laopscc患者接受2个周期的替利单抗（200 mg）、白蛋白结合紫杉醇（260 mg/m2）和顺铂（60-75 mg/m2）治疗，每个周期间隔3周；这种治疗之后是手术和辅助放疗或同步放化疗。主要终点是主要病理反应（MPR）率和安全性。结果在2022年3月至2023年6月期间，共有82例患者符合条件并完成了2个周期的新辅助治疗；影像学评价78例，手术及病理反应评价73例。40例患者接受原发肿瘤降级手术。1例患者避免了眶底切除术，5例患者避免了下颌切除术，32例患者避免了近全舌切除术或全舌切除术。客观缓解率为67.9%，MPR为60.3%，34.2%的患者达到病理完全缓解。中位随访时间为24个月，2年总生存率为84.4%，2年无事件生存率为76.7%。11例患者（13.4%）在新辅助治疗期间发生了3级或4级治疗相关不良事件。结论：tislelizumab联合化疗治疗laopscc获得了较高的病理反应率和良好的生存指标，安全性可接受。

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引用次数: 0