臨床早期口腔癌患者之預後因子探討

Prognostic Factors in Clinical Early Stage Oral Cavity Cancer

莊傑仰(Jie-Yang Jhuang) ； 羅武嘉(Wu-Chia Lo) ； 謝忱希(Chen-His Hsieh) ； 廖立人(Li-Jen Liao)

《台灣耳鼻喉頭頸外科雜誌》 50卷4期 (2015/12) Pp. 219-227

https://doi.org/10.6286/2015.50.4.219

摘要

背景：有報告指出共病症(co-morbidity)及癌症的分化不良(poor differentiation)是頭頸癌的不佳預後因子，然而針對cT1-2N0M0口腔癌，共病症與癌症分化對於預後的影響，過去並沒有研究。本研究旨在綜合探討多個臨床及病理因子對於此類口腔癌存活的影響。方法：回溯從2004年3月到2010年12月在亞東紀念醫院接受診斷及治療之cT1-2N0M0新期口腔癌，回顧患者之臨床及病理預後因子，以存活分析比較disease-free survival、overall survival，以Kaplan-Meier方法畫圖，針對各個變項再以單變項與多變項Cox迴歸分析，檢視哪些是相關的預後因子。結果：統計分析發現與overall survival有統計差異的是pT-classification、pN-classification、ECS、PNI、positive margin與poor differentiation，共病症CCI (Charlson Co-morbidity Index)並沒有明顯統計差異。經Cox多變項分析，發現與overall survival有統計差異的是年齡、pN-classification、PNI、positive margin與poor differentiation。Cox單變項分析與disease-free survival有統計差異的是年齡、pN-classification、ECS、PNI、close margin與positive margin，CCI也沒有統計差異。經Cox多變項分析，發現與disease-free survival有統計差異的是年齡、PNI、close margin與positive margin。結論：年齡、pT-classification、pN-classification、ECS、PNI、margin、poor differentiation，是新發cT1-2N0M0口腔癌的不佳預後因子，然而共病症CCI從研究結果看來並沒有統計差異。

關鍵字

口腔癌 ； 預後因子

並列摘要

BACKGROUND: According to relevant literature, comorbidities and poor differentiation of cancer cells are poor prognostic factors in head and neck cancer. However, the impacts of these two factors on cT1-2N0M0 oral cavity cancer have not been sufficiently evaluated. The aim of this study was to determine the effects of multiple clinical-pathological factors on cT1-2N0M0 oral cancer. METHODS: This is a retrospective review of cT1-2N0M0 oral cavity cancer patients who underwent diagnosis and treatment from March 2004 to December 2010 at Far Eastern Memorial Hospital. We reviewed multiple clinical-pathological factors and compared them with rates of overall and disease-free survival. We plotted the survival rates by using the Kaplan-Meier method and performed modeling by using Cox regression analysis. RESULTS: In univariate Cox regression analysis, pT-classification, pN-classification, ECS, positive margin, and poor differentiation were related to overall survival. In multivariate regression, age, pN-classification, PNI, positive margin and poor differentiation were related to rates of overall survival. In univariate regression analysis, age, pN-classification, ECS, PNI, and positive margin were related to disease-free survival. In multivariate regression, age, PNI, and positive margin were related to disease-free survival. However, CCI was not associated with overall or disease-free survival rates. CONCLUSIONS: Age, pT-classification, pN-classification, ECS, PNI, positive margin, and poor differentiation are poor prognostic factors in cT1-2N0M0 oral cancer. However, in contrast to age, co-morbidities were not associated with rates of survival in this study.

並列關鍵字

oral cavity cancer ； prognostic factors