Treatment Outcome and Prognosis of Oral Squamous Cell Carcinomas at a Single Institution-Experience From Chi Mei Medical Center, Liouying

Ching-Yi Yiu ； Tsuey-Pin Lin ； Chung-Han Ho ； Chien-Liang Lin ； Hui-Chen Hsu

《International Journal of Head and Neck Science》 5卷4期 (2021/12) Pp. 158-170

https://doi.org/10.6696/IJHNS.202112_5(4).0004

摘要

Background: The prognosis of oral squamous cell carcinoma (OSCC) is greatly influenced by clinical and pathological characteristics; the risk factor levels are crucial prognostic indicators. In this study, we evaluated factors influencing outcomes and set goals of treatment for improved survival in oral cancer. Methods: We retrospectively reviewed untreated oral cancer patients from January 2013 to December 2018 in Chi Mei Medical Center, Liouying. The tumor and nodal characteristics of these patients were analyzed. Tumor factors were divided into subgroups according to tumor size, differentiation, depth of invasion (DOI), perineural invasion, and lymphovascular invasion. Nodal status was defined by positive lymph nodes count, lymph node ratio (LNR), and extranodal extension. Results: In all 370 oral cancer patients, the 5-year overall survival rates for stages I, II, III, and IV were 74.9%, 60.4%, 50.4%, and 50.3%, respectively, with a significant p-value of 0.0004. In the buccal mucosa cancer group, pathological stage, DOI, and LNR were significant in univariate analysis, while only the LNR showed statistical significance in the multivariable analysis. In the tongue cancer group, pathological stage and surgical margin demonstrated significance in both univariate and multivariable analyses. Conclusions: OSCC is a worldwide public health burden. Radical surgery with comprehensive neck dissection to obtain adequate surgical margins is determined to provide oncologic benefits. Otherwise, effective routine medical management and multidisciplinary teamwork may be the keys to improving the survival of oral cancer patients.

關鍵字

perineural invasion ； lymph node ratio ； extranodal extension ； immunotherapy ； multidisciplinary