- 作者：Chun-Ta Liao M.D.&lowast ; ; ; &dagger ; ; ; liaoct@adm.cgmh.org.tw ; Li-Yu Lee MD.&dagger ; ; ; &Dagger ; ; Shiang-Fu Huang MD.&lowast ; ; ; &dagger ; ; I-How Chen M.D.&lowast ; ; ; &dagger ; ; Chung-Jan Kang M.D.&lowast ; ; ; &dagger ; ; Chien-Yu Lin M.D.&dagger ; ; ; § ; ; Kang-Hsing Fan M.D.&dagger ; ; ; § ; ; Hung-Ming Wang M.D.&dagger ; ; ; ¶ ; ; Shu-Hang Ng M.D.&dagger ; ; ; ?/sup> ; Tzu-Chen Yen M.D. ; Ph.D.&dagger ; ; ; &lowast ; &lowast ; ; ; yen1110@adm.cgmh.org.tw
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2011
- 出版时间：15 November 2011
- 年：2011
- 卷：81
- 期：4
- 页码：930-937
- 全文大小：448 K
Purpose
Extracapsular spread (ECS) in neck lymph nodes is a major adverse prognostic factor in patients with oral cavity squamous cell carcinoma (OSCC). We conducted a retrospective analysis of prognostic factors in this patient group and tried to identify a subset of patients with a worse prognosis suitable for more aggressive therapeutic interventions.Methods and Materials
Enrolled in the study were 255 OSCC patients with ECS in neck nodes and without evidence of distant metastasis. All participants were followed-up for at least 2 years or censored at last follow-up. The 5-year rates of control, distant metastasis, and survival were the main outcome measures.
Results
Level IV/V lymph node metastases and tumor depth ?2 mm were independent predictors of 5-year survival and identified three prognostic groups. In the low-risk group (no level IV/V metastases and tumor depth <12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 60 % , 66 % , and 50 % , respectively. In the intermediate-risk group (no level IV/V metastases and tumor depth ?2 mm), the 5-year disease-free, disease-specific, and overall survival rates were 39 % , 41 % , and 28 % , respectively. In the high-risk group (evidence of level IV/V metastases), the 5-year disease-free, disease-specific, and overall survival rates were 14 % , 12 % , and 10 % , respectively.
Conclusions
Among OSCC patients with ECS, those with level IV/V metastases appear to have the worst prognosis followed by without level IV/V metastases and tumor depth ?2 mm. An aggressive therapeutic approach may be suitable for intermediate- and high-risk patients.