口腔癌治療後影響局部復發之相關因素分析

Factors Analysis of Loco-regional Recurrence in Patients with Oral Cavity Cancer

詹日全(Jih-Chuan Jan) ； 黃穰基(Yong-Kie Wong) ； 潘超群(Chiu-Kwan Poon) ； 王仲祺(Chen-Chi Wang) ； 王景平(Ching-Ping Wang) ； 劉時安(Shih-An Liu)

《台灣耳鼻喉頭頸外科雜誌》 42卷4期 (2007/08) Pp. 115-127

https://doi.org/10.6286/2007.42.4.115

摘要

BACKGROUND: Oral cavity cancer is the most frequent type of head and neck cancer in Taiwan. Tumor recurrence is a troublesome issue in the management of oral cavity cancer. It influences not only the therapeutic outcome but also patients' survival. The aim of this study was to investigate the associated factors between patients with and without loco-regional recurrence after primary treatment. We also wanted to determine whether socio-demographic factors had any impact on loco-regional recurrence.
METHODS: From March 1995 to December 2002, those admitted to cased hospital with surgical intervention for oral cavity cancer were enrolled for study. Over 1200 chart records were retrospectively reviewed. Relevant clinical features such as tumor location, tumor staging, treatment modalities, surgical margin, neck metastasis, and so on, were compared with recurrent status. Socio-demographic factors such as marital status, religious affiliation, educational level, and occupation were also recorded and analyzed.
RESULTS: There were a total of 862 patients included in the final analyses. Male patients accounted for 94.4% (n=814) of oral cavity cancer patients and the average age was 51.61 years (±11.44 years). Loco-regional recurrence rate was 43.6% (n=376). Risk factors for loco-regional recurrence included: those who were single, widow/widower, or separated (odds ratio: 1.945, p=0.005), those without religious beliefs (odds ratio: 1.399, p=0.028), unemployed (odds ratio: 2.172, p＜0.001), tumors located over retromolar trigone (odds ratio: 5.161, p=0.021), extra-capsular spread of lymph node (odds ratio: 3.207, p＜0.001), and advanced tumor stage (odds ratio: 2.245, p＜0.001). The average loco-regional recurrent period was 21.40 months (±14.76 months).
CONCLUSION: Loco-regional recurrence in oral cavity cancer patients after primary treatment is strongly associated with the initial tumor stage and the extra-capsular spread of lymph nodes. The retromolar trigone squamous cell carcinoma tends to develop loco-regional recurrence. Furthermore, socio-demographic factors significantly influenced loco-regional recurrence in oral cavity cancer patients after primary treatment. Therefore, health care providers should take socio-psychological issues into consideration aside from ordinary clinical health care.

關鍵字

口腔癌 ； 局部區域復發

並列摘要

BACKGROUND: Oral cavity cancer is the most frequent type of head and neck cancer in Taiwan. Tumor recurrence is a troublesome issue in the management of oral cavity cancer. It influences not only the therapeutic outcome but also patients' survival. The aim of this study was to investigate the associated factors between patients with and without loco-regional recurrence after primary treatment. We also wanted to determine whether socio-demographic factors had any impact on loco-regional recurrence.
METHODS: From March 1995 to December 2002, those admitted to cased hospital with surgical intervention for oral cavity cancer were enrolled for study. Over 1200 chart records were retrospectively reviewed. Relevant clinical features such as tumor location, tumor staging, treatment modalities, surgical margin, neck metastasis, and so on, were compared with recurrent status. Socio-demographic factors such as marital status, religious affiliation, educational level, and occupation were also recorded and analyzed.
RESULTS: There were a total of 862 patients included in the final analyses. Male patients accounted for 94.4% (n=814) of oral cavity cancer patients and the average age was 51.61 years (±11.44 years). Loco-regional recurrence rate was 43.6% (n=376). Risk factors for loco-regional recurrence included: those who were single, widow/widower, or separated (odds ratio: 1.945, p=0.005), those without religious beliefs (odds ratio: 1.399, p=0.028), unemployed (odds ratio: 2.172, p＜0.001), tumors located over retromolar trigone (odds ratio: 5.161, p=0.021), extra-capsular spread of lymph node (odds ratio: 3.207, p＜0.001), and advanced tumor stage (odds ratio: 2.245, p＜0.001). The average loco-regional recurrent period was 21.40 months (±14.76 months).
CONCLUSION: Loco-regional recurrence in oral cavity cancer patients after primary treatment is strongly associated with the initial tumor stage and the extra-capsular spread of lymph nodes. The retromolar trigone squamous cell carcinoma tends to develop loco-regional recurrence. Furthermore, socio-demographic factors significantly influenced loco-regional recurrence in oral cavity cancer patients after primary treatment. Therefore, health care providers should take socio-psychological issues into consideration aside from ordinary clinical health care.

並列關鍵字

oral cavity cancer ； loco-regional recurrence