口腔鱗狀細胞癌存活率之相關研究

A Study on Survival Rates of Oral Squamous Cell Carcinoma

陳金勝(Gean-Shun Chen) ； 陳中和(Chung-Ho Chen)

《The Kaohsiung Journal of Medical Sciences》 12卷6期 (1996/06) Pp. 317-325

https://doi.org/10.6452/KJMS.199606.0317

摘要

口腔癌是一種好發於40-69歲中老年男性的疾病，而口腔惡性腫瘤中約90%是口腔解狀細胞癌。一般在治療上以手術切除為主，比較末期的病人視情況合併放射線治療和化學治療。本研究回顧了1987至1991年間，高雄醫學院口腔顎面外科經臨床診斷及病理切片檢查證實為口腔鱗狀細胞癌的患者共計有211人，其中接受手術治療者103位，年齡從23歲到87歲，男性92人，女性11人。其中侵犯部位以頰黏膜最多佔39.8 %，其次是舌部位27.2 %，牙齦等其他各部位合計佔33%。在臨床分期方面以第三期最多，佔43.7 %，其次分別是第一期（23.3%）、第四期（18.4%）、第二期（14.6%）。在103位接受腫瘤切除手術者當中有65%（67/103）的患者並接受頸部廓清術或舌骨上頸部廓清術，另外有41%（42/103）的患者在術後合併放射線治療。治療後大多數患者都回本院追蹤檢查；未回本院追蹤檢查者，則以電話訪問或以各地戶政事務所資料追查患者存活情形。所有患者除4人之外，都追蹤滿3年或至其死亡。其中性別和年齡對存活率的影響在3年內並不明顯，第一期至第四期患者的5年存活率分別是62%、80%、42%、19%，而早期口腔癌患者各部位別5年存活率在58%-75%間，並無明顯差異。不過對於末期患者，黏膜腫瘤患者的5年存活率是53%，明顯的高於其他部位只有15%的5年存活率（p=0.0174）。雖然口內各部位腫瘤存活率有差異，但早期治療者的存活率都遠比末期患者好，因此早期發現早期治療是非常重要的。

並列摘要

Oral squamous cell carcinoma is seen predominantly after the fourth decade of life. We have retrospectively reviewed 103 patients (92 males and 11 females) with squamous cell carcinoma, which were confirmed by histopathologic examination and treated by surgical excision at Kaohsiung Medical College Hospital from 1987 to 1991. The age of the patients ranged from 23 to 87 years. 39.8% of cases occurred on the buccal mucosa, 27.2% on the tongue, 15.5% on the gingiva of mandible, 8% on the maxilla, 7.8% on the lower lip and 1% on the floor of the mouth. 23.3% of the patients had stage I disease, 14.6% were stage II, 43.7% were stage III and 18.4% stage IV. Of 103 patients treated with wide excision, about 65% (17 /103) of patients treated with wide excision and radical neck dissection or suprahyoid neck dissection, and 41% (42/103) were treated by a combination of radiation and surgery. 96% (99/ 103) of our cases have completed a minimum follow-up period of 3 years. The sex and age of the patients did not influence survival significantly. The 5-year survival rates were 62% for patients with stage I disease, 80% for patients with stage II disease, 42% for patients with stage III, and 19% for patients with stage IV disease. Stage at initial presentation was an important factor influencing survival. The location of the primary tumor did not significantly influence survival for early stage tumors (stage I & II). In terminal stage tumors (stage III & IV). those with carcinomas of the floor of the mouth, gingiva of the mandible, lip, and maxilla had a 5-year survival of 15%, those with carcinomas of the tongue had a 5-year survival of 47%, and those with carcinomas of the buccal mucosa had a favorable survival rate of 53%. The differences were significant (P=0.017).

並列關鍵字

squamous cell carcinoma ； survival rate