接受手术但未接受辅助治疗的早期口腔舌鳞状细胞癌患者初始阴性切除边缘与修正阴性切除边缘的比较

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

Oral oncology Pub Date : 2024-09-27 DOI:10.1016/j.oraloncology.2024.107046

Jun Young Kim , Younghac Kim , Eun Hye Kim , Man Ki Chung , Han-Sin Jeong , Chung-Hwan Baek , Young-Ik Son , Nayeon Choi

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引用次数: 0

摘要

背景在切除边缘（RM）阳性的病例中，一般建议再次切除。关于再次切除后阴性RM的肿瘤学影响一直存在争议。本研究的目的是调查早期（pT1-2/N0）口腔舌鳞状细胞癌（OSCC）患者在未接受辅助治疗的情况下接受手术治疗后，修订后的阴性 RM 对肿瘤的影响。这些患者被分为初始阴性RM（R0，380人）组和修正阴性RM（R1-R0，61人）组。比较了R0组和R1-R0组的人口统计学和临床数据（T分期、肿瘤长度、浸润深度[DOI]、淋巴管浸润[LVI]、神经周围浸润[PNI]和复发）。结果两组患者的年龄、性别、T分期、DOI、LVI、PNI和SUVmax无显著差异。R1-R0组（13.1%）的局部复发率（P=0.045）高于R0组（5.5%）。R0组的无局部复发生存率高于R1-R0组（P=0.046）。总复发率和总生存率没有明显差异。多变量分析显示，初始阳性RM是局部复发的独立显著风险因素（危险比，2.249；95%置信区间，1.025-4.935；P=0.043）。早期OSCC患者在初始切缘清晰后出现修正切缘，是局部复发的危险因素，应慎重考虑。

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Initial negative resection margin versus revised negative resection margin in patients who underwent surgery without adjuvant therapy for early-stage oral tongue squamous cell carcinoma

Background

In cases of positive resection margin (RM), re-resection is generally recommended. There has been controversy about the oncologic impact of revised negative RMs after re-resection. The aim of this study was to investigate the oncologic impact of revised negative RM in patients who underwent surgery without adjuvant therapy for early-stage (pT1-2/N0) oral tongue squamous cell carcinoma (OSCC).

Methods

We retrospectively analyzed patients with pT1-2 N0 OSCC who did not receive adjuvant therapy (N=441). These patients were classified into an initial negative RM (R0, n = 380) group and a revised negative RM (R1-R0, n = 61) group. Demographic and clinical data (T stage, tumor length, depth of invasion [DOI], lymphovascular invasion [LVI], perineural invasion [PNI], and recurrence) were compared between the R0 and R1-R0 groups.

Results

Age, sex, T stage, DOI, LVI, PNI, and SUVmax were not significantly different between the two groups. Local recurrence was more frequent (P=0.045) in the R1-R0 group (13.1 %) than in the R0 group (5.5 %). Local recurrence-free survival was better in the R0 group than in the R1-R0 group (P=0.046). There was no significant difference in overall recurrence or overall survival. On multivariate analysis, initial positive RM was the independent significant risk factor (hazard ratio, 2.249; 95 % confidence interval, 1.025–4.935; P=0.043) for local recurrence.

Conclusion

A revised clear RM after initial cut-through margin is a risk factor for local recurrence in early-stage OSCC. Cautious should be considered in early-stage OSCC patients with revised clear RM.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.