目的:本研究旨在评估诊断为口腔鳞状细胞癌(OSCC)的患者的五年总生存率(OS)和术后生存时间。以及检查影响OSCC患者生存结局的临床和病理因素。
方法:收集2014年4月至2016年12月在重庆医科大学附属第一医院颌面外科接受首次根治性手术干预的OSCC患者的数据。后续行动一直持续到2022年3月。
结果:本研究共纳入162名患者。观察到的5年OS率为59.3%。约45.7%的OSCC患者术后复发或转移,5年总体无病生存率为49.4%。性别的影响没有显著差异,年龄,吸烟,酒精消费,原发性肿瘤位置,浸润深度或原发肿瘤大小对5年生存率的影响(p>0.05)。单因素分析显示临床分期(危险比=2.239,p=0.004),神经周浸润(PNI)(危险比=1.712,p=0.03),淋巴结转移(pN)(危险比=2.119,p=0.002),病理分化(危险比=2.715,p<0.001),复发或转移(危险比=10.02,p<0.001)是影响生存的重要因素。多变量分析进一步表明病理分化(危险比=2.291,p=0.001),PNI(危险比=1.765,p=0.031)和复发或转移(危险比=9.256,p<0.001)是生存的独立危险因素。有趣的是,11例OSCC患者在手术后1-4年内被诊断为食管鳞状细胞癌(ESCC)。
结论:OSCC患者的生存预后与临床分期显著相关,PNI,淋巴结转移,病理分化,复发或转移。病理分化,PNI和复发或转移是影响患者生存的独立危险因素。对于有饮酒和吸烟史的OSCC患者,建议进行ESCC的常规临床筛查。
OBJECTIVE: This study was designed to evaluate the five-year overall survival (OS) rate and postoperative survival time of patients diagnosed with oral squamous cell carcinoma (OSCC), as well as examine the clinical and pathological factors influencing survival outcomes in OSCC patients.
METHODS: Data were collected from OSCC patients who underwent their first radical surgical intervention in the Department of Maxillofacial Surgery at the First Affiliated Hospital of Chongqing Medical University between April 2014 and December 2016. Follow-up was conducted until March 2022.
RESULTS: The study included a total of 162 patients. The observed 5-year OS rate was 59.3%. Approximately 45.7% of OSCC patients experienced postoperative recurrence or metastasis, with a 5-year overall disease-free survival rate of 49.4%. There was no significant difference in the impact of sex, age, smoking, alcohol consumption, primary tumour location, depth of invasion or primary tumour size on the 5-year survival rate (p > 0.05). Univariate analysis revealed that clinical stage (Hazard Ratio = 2.239, p = 0.004), perineural invasion (PNI) (Hazard Ratio = 1.712, p = 0.03), lymph node metastasis (pN) (Hazard Ratio = 2.119, p = 0.002), pathological differentiation (Hazard Ratio = 2.715, p < 0.001), and recurrence or metastasis (Hazard Ratio = 10.02, p < 0.001) were significant factors influencing survival. Multivariate analysis further indicated that pathological differentiation (Hazard Ratio = 2.291, p = 0.001), PNI (Hazard Ratio = 1.765, p = 0.031) and recurrence or metastasis (Hazard Ratio = 9.256, p < 0.001) were independent risk factors of survival. Intriguingly, 11 OSCC patients were diagnosed with oesophageal squamous cell carcinoma (ESCC) within 1-4 years following surgery.
CONCLUSIONS: The survival prognosis of OSCC patients is significantly associated with clinical stage, PNI, lymph node metastasis, pathological differentiation, and recurrence or metastasis. Pathological differentiation, PNI and recurrence or metastasis are independent risk factors affecting survival. Routine clinical screening for ESCC may be recommended for OSCC patients with a history of alcohol consumption and tobacco use.