Abstract：
OBJECTIVE: Despite sharing the same staging system as oral cavity cancers, upper gingiva and hard palate (UGHP) squamous cell carcinoma (SCC) have several features that make them a different entity. We aimed to analyze oncological outcomes and adverse prognostic factors of UGHP SCC, and assess an alternate T classification specific to UGHP SCC.
METHODS: Retrospective bicentric study including all patients treated by surgery for a UGHP SCC between 2006 and 2021.
RESULTS: We included 123 patients with a median age of 75 years. After a median follow-up of 45 months, the 5-year overall survival (OS), disease-free survival (DFS) and local control (LC) were 57.3%, 52.7% and 74.7%, respectively. Perineural invasion, tumor size, bone invasion, pT classification and pN classification were statistically associated with poorer OS, DFS and LC on univariate analysis. On multivariable analysis, the following variable were statistically associated with a poorer OS: past history of HN radiotherapy (p = 0.018), age > 70 years (p = 0.005), perineural invasions (p = 0.019) and bone invasion (p = 0.030). Median survivals after isolated local recurrence were 17.7 and 3 months in case of surgical and non-surgical treatment, respectively (p = 0.066). The alternate classification allowed better patient distribution among T-categories, however without improving prognostication.
CONCLUSIONS: There is a broad variety of clinical and pathological factors influencing prognosis of SCC of the UGHP. A comprehensive knowledge of their prognostic factors may pave the way towards a specific and more appropriate classification for these tumors.
METHODS: Retrospective bicentric study including all patients treated by surgery for a UGHP SCC between 2006 and 2021.
RESULTS: We included 123 patients with a median age of 75 years. After a median follow-up of 45 months, the 5-year overall survival (OS), disease-free survival (DFS) and local control (LC) were 57.3%, 52.7% and 74.7%, respectively. Perineural invasion, tumor size, bone invasion, pT classification and pN classification were statistically associated with poorer OS, DFS and LC on univariate analysis. On multivariable analysis, the following variable were statistically associated with a poorer OS: past history of HN radiotherapy (p = 0.018), age > 70 years (p = 0.005), perineural invasions (p = 0.019) and bone invasion (p = 0.030). Median survivals after isolated local recurrence were 17.7 and 3 months in case of surgical and non-surgical treatment, respectively (p = 0.066). The alternate classification allowed better patient distribution among T-categories, however without improving prognostication.
CONCLUSIONS: There is a broad variety of clinical and pathological factors influencing prognosis of SCC of the UGHP. A comprehensive knowledge of their prognostic factors may pave the way towards a specific and more appropriate classification for these tumors.
摘要：
目标：尽管与口腔癌有相同的分期系统，上牙龈和硬腭（UGHP）鳞状细胞癌（SCC）具有使它们成为不同实体的几个特征。我们旨在分析UGHPSCC的肿瘤学结果和不良预后因素，并评估UGHPSCC特有的替代T分类。
方法：回顾性双中心研究，包括2006年至2021年期间接受UGHPSCC手术治疗的所有患者。
结果：我们纳入了123例患者，中位年龄为75岁。经过45个月的中位随访，5年总生存期（OS），无病生存率（DFS）和局部控制（LC）为57.3%，52.7%和74.7%，分别。神经周浸润,肿瘤大小,骨侵入,pT分类和pN分类与较差的OS有统计学关联，单变量分析的DFS和LC。在多变量分析中，以下变量在统计学上与较差的OS相关：既往HN放疗史（p=0.018），年龄>70岁(p=0.005)，神经周浸润（p=0.019）和骨浸润（p=0.030）。在手术和非手术治疗的情况下，孤立的局部复发后的中位生存期分别为17.7和3个月。分别（p=0.066）。替代分类允许T类别中更好的患者分布，然而，没有改善预后。
结论：影响UGHPSCC预后的临床和病理因素多种多样。对其预后因素的全面了解可能会为这些肿瘤的特定和更合适的分类铺平道路。
方法：回顾性双中心研究，包括2006年至2021年期间接受UGHPSCC手术治疗的所有患者。
结果：我们纳入了123例患者，中位年龄为75岁。经过45个月的中位随访，5年总生存期（OS），无病生存率（DFS）和局部控制（LC）为57.3%，52.7%和74.7%，分别。神经周浸润,肿瘤大小,骨侵入,pT分类和pN分类与较差的OS有统计学关联，单变量分析的DFS和LC。在多变量分析中，以下变量在统计学上与较差的OS相关：既往HN放疗史（p=0.018），年龄>70岁(p=0.005)，神经周浸润（p=0.019）和骨浸润（p=0.030）。在手术和非手术治疗的情况下，孤立的局部复发后的中位生存期分别为17.7和3个月。分别（p=0.066）。替代分类允许T类别中更好的患者分布，然而，没有改善预后。
结论：影响UGHPSCC预后的临床和病理因素多种多样。对其预后因素的全面了解可能会为这些肿瘤的特定和更合适的分类铺平道路。
