Second Primary Oral Cancers after Curative Surgery

口腔癌患者接受根治性手術後產生的第二原發癌

陳怡孜(Yi-Tzu Chen) ； 邱昱瑋(Yu-Wei Chiu) ； 陳彥霖(Yen-Lin Chen) ； 陳珮吟(Pei-Yin Chen) ； 呂明怡(Ming-Yi Lu) ； 彭芷瑜(Chih-Yu Peng)

《臺灣口腔顎面外科學會雜誌》 31卷4期 (2020/12) Pp. 307-317

摘要

Background: Multiple malignancies or recurrences in the oral cavity after initial treatment still represent a critical challenge in the management of oral cancer patients. Second primary cancers have the greatest impact on the survival rates of patients, and their treatment may be more challenging because of the limitations arising from the previous surgeries and irradiation. Objectives: This retrospective observational study was designed to analyze the overall outcomes of patients with second primary cancers who had undergone curative surgeries previously. Secondary objectives were to examine the overall survival rates following the treatment of the second primary cancers in relation to the timing of their occurrence. Methods: The medical records were extracted from the Chung Shan Medical University Hospital. Eligible patients included those treated with definitive surgery, or surgery followed by adjuvant therapy, or induction chemotherapy followed by surgery for an index oral cancer during 2008-2014. Findings and Conclusion: In our eligible patients' data, there was no significant difference in the overall survival rates between patients with second primary cancers and those with single cancer; however, those with an earlier occurrence of second primary cancer had lower survival rates. Since, the use of postoperative adjuvant therapy for patients with second primary cancers is controversial; we strongly recommend aggressive surgical treatment for second primary cancers in indicated patients.

關鍵字

Oral cancer ； Second primary cancers ； Surgery ； Survival rate ； Adjuvant therapy

並列摘要

背景：在初次口腔癌治療後產生了口腔其他部位惡性腫痛或腫瘤的復發，對於治癌醫師是一種挑戰。第二原發癌對患者的存活率影響很大。由於先前手術和放射線治療的限制，第二原發癌的治療可能也更加因難。目的：這項回顧性研究目的要分析先前接受過根治性手術的第二原發癌患者的存活率。其次要分析第二原發癌治療後的整體存活率與發生時間的關係。方法：自中山醫學大學附屬醫院，收集從2008年至2014年期間接受根除性手術的口腔癌患者，其中也包括手術後輔助治療，及先進行過引導化學治療後再手術治療口腔癌的患者。結果與結論：在我們所設定的條件選擇之下，可以看到第二原發癌與單一口腔癌兩組之間的總生存率無顯著差異，但較早發生第二原發癌具有較低的存活率。第二原發癌患者的術後輔助治療似乎仍存有爭議。我們仍強烈建議在產生了第二原發癌的合適的患者上採取積極的外科治療。

並列關鍵字

口腔癌 ； 第二原發癌 ； 手術 ； 存活率 ； 輔助治療