[组织学证实的早期口腔癌根治性切除术后的随访:一项前瞻性多中心研究的结果]。

M Wolfensberger, S Albrecht, W Müller, P Zbären, P Dulguerov, A Arnoux, S Schmid
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引用次数: 0

摘要

简介:早期口腔癌在大多数情况下是可以治愈的。本研究追踪早期口腔鳞状细胞癌根治性手术切除后的病程,以评估进一步治疗方式的必要性。材料和方法:在一项前瞻性多中心研究中,纳入了110例T1-T2和N0-N1(未侵犯包膜)口腔鳞状细胞癌患者。所有患者均接受组织病理学证实为阴性的手术切除治疗。结果:96例患者(14例因切缘阳性排除),随访3年,18例出现局部或区域复发。在这18例中,有12例通过第二次治疗恢复了局部-区域控制。总体而言,4年疾病特异性生存率为94%。最初接受选择性颈部清扫手术的患者复发率明显低于未接受颈部手术的患者。结论:早期(T1-2, N0-1)口腔鳞状细胞癌单手术治疗效果良好。手术程序应包括原发癌无边缘切除结合选择性颈部清扫。系统的术后放疗似乎没有必要。颈部清扫术在0例患者中也被提倡。
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[Follow-up after histologically verified radical resection of early cancers of the mouth cavity: results of a prospective multicenter study].

Introduction: Early stage oral cavity carcinoma is curable in most cases. This study follows the course of early stage squamous cell carcinoma of the oral cavity after radical surgical resection, in order to assess the necessity of further treatment modalities.

Material and methods: In a prospective multicentric study, 110 patients with T1-T2 and N0-N1 (without capsular invasion) squamous cell carcinoma of the oral cavity were enrolled. All patients were treated exclusively by surgical resection with histopathologically proven negative margins.

Results: Among 96 patients (14 excluded because of positive margins), followed-up for 3 years, 18 presented a local or regional recurrence. In 12 of these 18 loco-regional control was reestablished by second treatment. Overall, the 4-year disease-specific survival probability was 94%. Patients treated initially by selective neck dissection had significantly lower recurrence rates than those without neck surgery.

Conclusion: Early (T1-2, N0-1) squamous cell carcinoma of the oral cavity is adequately treated by surgery alone. The surgical procedure should include margin-free resection of the primary combined with selective neck dissection. Systematic postoperative radiotherapy does not appear necessary. Neck dissection is advocated in N0 patients as well.

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