METHODS: A retrospective study was made of 205 consecutive patients with primary tongue cancer subjected to surgery and adjuvant therapy according to the stage of the disease, in Hospital Clínico Universitario Virgen de la Arrixaca (HUVA) (Murcia, Spain) during the period 2000-2020. Survival was evaluated based on the Kaplan-Meier method, and the existence of significant differences between the different study variables was analyzed using the log-rank test. Cox regression analysis was performed for the identification of risk factors.
RESULTS: In relation to overall survival, 72.6% of the patients survived for a mean time of 14.43 years [standard error (SE) = 0.74; 95% CI: 12.98-15.87], with a cumulative survival rate of 49.8 ± 3%. Survival was reduced by the presence of tumor adjacent to resection margins [hazard ratio (HR) 2.20; 95% CI 1.09-4.43] (p = 0.028) and infiltrated resection margins (HR 3.86, 95% CI 1.56-9.57) (p = 0.004). Lymphadenectomy in turn increased survival (HR 0.15; 95% CI 0.06-0.42) (p < 0.001). In relation to disease-free survival, 55.3% of the patients suffered no relapse over a mean period of 9.91 years (SE = 0.66; 95% CI: 8.61-11.2), with a cumulative survival rate of 26.6% ± 8.4%.
CONCLUSIONS: In tongue cancer patients, overall and specific survival were reduced in the presence of infiltrated resection margins. Lymphadenectomy in turn improved survival compared with patients in which this procedure was not carried out.
方法:对205例原发性舌癌患者进行回顾性研究,根据疾病的分期进行手术和辅助治疗。在医院ClínicoVirgendelaArrixaca大学(HUVA)(穆尔西亚,西班牙)在2000-2020年期间。根据Kaplan-Meier方法评估生存率,并使用对数秩检验分析不同研究变量之间是否存在显著差异。对危险因素进行Cox回归分析。
结果:关于总生存期,72.6%的患者平均存活时间为14.43年[标准误差(SE)=0.74;95%CI:12.98-15.87],累积生存率为49.8±3%。存在邻近切除边缘的肿瘤[风险比(HR)2.20;95%CI1.09-4.43](p=0.028)和浸润切除边缘(HR3.86,95%CI1.56-9.57)(p=0.004)降低了生存率。淋巴结清扫术可提高生存率(HR0.15;95%CI0.06-0.42)(p<0.001)。关于无病生存,55.3%的患者在平均9.91年的时间内没有复发(SE=0.66;95%CI:8.61-11.2),累积生存率为26.6%±8.4%。
结论:在舌癌患者中,在存在浸润性切除边缘的情况下,总生存率和特异性生存率降低.与未进行此手术的患者相比,淋巴结清扫术反过来提高了生存率。