Abstract：
OBJECTIVE: To determine the significance of depth of invasion as a predictor of recurrence and mortality in tongue and non-tongue early-stage oral cavity squamous cell carcinoma patients treated with surgery and no postoperative radiotherapy.
METHODS: 344 patients with oral cavity squamous cell carcinoma from 2005 to 2022 at a tertiary academic medical center were reviewed. Patients were included if they had newly diagnosed, previously untreated T1-T2N0 disease treated with surgery alone that was observed within a follow-up of 5 years. For each patient, anatomic site of oral cavity squamous cell carcinoma was categorized as either tongue or non-tongue. Cox proportional hazards regression analyses were performed to determine the association of depth of invasion with recurrence and mortality, with anatomic site, smoking status, and age at biopsy as covariates. Model assumptions were tested by statistical and graphical evaluation using Schoenfeld residuals.
RESULTS: Of 108 patients with T1-T2N0 disease, 78 (72.2 %) had tongue disease, and 30 (27.8 %) had non-tongue disease. Median follow-up was 18.2 months (range, 0.01-58.2 months). In the Cox proportional hazards models, with adjustment for anatomic site and other covariates, depth of invasion positively predicted recurrence (HR 1.16, 95 % CI: 1.01-1.32, p = 0.034) and death (HR 1.42, 95 % CI: 1.11-1.83, p = 0.006).
CONCLUSIONS: Depth of invasion is an independent predictor of recurrence and death across early-stage tongue and non-tongue squamous cell carcinoma. Therefore, depth of invasion may indicate a need for more aggressive treatment than surgery alone, such as postoperative radiotherapy, even in the absence of other adverse features on pathology within the early-stage population.
METHODS: 344 patients with oral cavity squamous cell carcinoma from 2005 to 2022 at a tertiary academic medical center were reviewed. Patients were included if they had newly diagnosed, previously untreated T1-T2N0 disease treated with surgery alone that was observed within a follow-up of 5 years. For each patient, anatomic site of oral cavity squamous cell carcinoma was categorized as either tongue or non-tongue. Cox proportional hazards regression analyses were performed to determine the association of depth of invasion with recurrence and mortality, with anatomic site, smoking status, and age at biopsy as covariates. Model assumptions were tested by statistical and graphical evaluation using Schoenfeld residuals.
RESULTS: Of 108 patients with T1-T2N0 disease, 78 (72.2 %) had tongue disease, and 30 (27.8 %) had non-tongue disease. Median follow-up was 18.2 months (range, 0.01-58.2 months). In the Cox proportional hazards models, with adjustment for anatomic site and other covariates, depth of invasion positively predicted recurrence (HR 1.16, 95 % CI: 1.01-1.32, p = 0.034) and death (HR 1.42, 95 % CI: 1.11-1.83, p = 0.006).
CONCLUSIONS: Depth of invasion is an independent predictor of recurrence and death across early-stage tongue and non-tongue squamous cell carcinoma. Therefore, depth of invasion may indicate a need for more aggressive treatment than surgery alone, such as postoperative radiotherapy, even in the absence of other adverse features on pathology within the early-stage population.
摘要：
目的：确定浸润深度作为预测舌癌和非舌癌早期口腔鳞状细胞癌患者手术治疗和无术后放疗复发和死亡的意义。
方法：回顾性分析2005-2022年某三级学术医学中心收治的344例口腔鳞状细胞癌患者。如果新诊断的患者被包括在内，以前未经治疗的T1-T2N0疾病，单独手术治疗，在5年的随访中观察到。对于每个病人来说,口腔鳞状细胞癌的解剖部位分为舌或非舌。进行Cox比例风险回归分析以确定侵袭深度与复发和死亡率的关系。解剖部位，吸烟状况,和活检时的年龄作为协变量。使用Schoenfeld残差通过统计和图形评估来检验模型假设。
结果：在108例T1-T2N0病患者中，78人（72.2%）患有舌病，30例（27.8%）患有非舌病。中位随访时间为18.2个月(范围，0.01-58.2个月）。在Cox比例风险模型中，随着解剖部位和其他协变量的调整，侵袭深度正预测复发(HR1.16,95%CI:1.01-1.32,p=0.034)和死亡(HR1.42,95%CI:1.11-1.83,p=0.006)。
结论：浸润深度是早期舌癌和非舌鳞状细胞癌复发和死亡的独立预测因子。因此,侵入深度可能表明需要比单独手术更积极的治疗，如术后放疗，即使在早期人群中没有其他病理不良特征。
方法：回顾性分析2005-2022年某三级学术医学中心收治的344例口腔鳞状细胞癌患者。如果新诊断的患者被包括在内，以前未经治疗的T1-T2N0疾病，单独手术治疗，在5年的随访中观察到。对于每个病人来说,口腔鳞状细胞癌的解剖部位分为舌或非舌。进行Cox比例风险回归分析以确定侵袭深度与复发和死亡率的关系。解剖部位，吸烟状况,和活检时的年龄作为协变量。使用Schoenfeld残差通过统计和图形评估来检验模型假设。
结果：在108例T1-T2N0病患者中，78人（72.2%）患有舌病，30例（27.8%）患有非舌病。中位随访时间为18.2个月(范围，0.01-58.2个月）。在Cox比例风险模型中，随着解剖部位和其他协变量的调整，侵袭深度正预测复发(HR1.16,95%CI:1.01-1.32,p=0.034)和死亡(HR1.42,95%CI:1.11-1.83,p=0.006)。
结论：浸润深度是早期舌癌和非舌鳞状细胞癌复发和死亡的独立预测因子。因此,侵入深度可能表明需要比单独手术更积极的治疗，如术后放疗，即使在早期人群中没有其他病理不良特征。
