口腔癌之數後存活分析與其影響因素之探討

Postoperative Survival Analysis and Its Affecting Factors Investigation of the Oral Cancer

石璧瑜(Pi-Yu Shih)

指導教授 ： 藍守仁

亞洲大學/健康學院/健康產業管理學系健康管理組/碩士(2010年)

摘要

背景：
口腔癌為國人十大癌症之一，根據國健局96 年癌症登記年報指出，
在男性發生率及死亡率自民國86 年起皆維持在第四名，自民國87 年
到96 年，為男性10 大癌症年齡標準化發生率增加幅度最大(約13.1
倍)和死亡情形增加最快者。
研究目的：
目前國內尚無針對口腔癌所收集的核心指標與手術治療成效做進一
步探討，本研究希望能提供本土性口腔癌手術後相關核心指標項目與
存活率之相關性，提供國家衛生單位或其他研究之參考資料。
研究方法：
本研究是採用中部某醫學中心癌症登記所收錄之內容，加上核心指標
項目，以確定存活率之相關因素。收錄內容包括性別、年齡、口腔習
慣(菸、酒、檳榔)、腫瘤大小、發生部位、頸部淋巴轉移、臨床或病
理分期、組織分化程度、各治療日期、最後連絡日期及存活狀態。
結果：
本研究男性有239 人（90.5％）、女性有25 位（9.5％），男女性別比
為9.56：1，男性平均診斷年齡較低為49.87±10.4 歲；而女性為56±13.7
歲。診斷部位以舌癌及頰黏膜癌為最多，組織型態皆為鱗狀細胞癌。
由Kaplan-Meier Analysis 整體存活率為57.046±1.751 個月和Log-Rank
Test 及Cox regression 發現4 項手術相關因子最具有影響存活率
(P<0.05)，分別有周邊神經(Perinural)侵犯、淋巴節清除大於10 顆、
淋巴結報告呈陽性、腫瘤大小。
結論：
外科手術為治療口腔癌最主要的選擇，在手術方面的規範國內未有實
際的明確規範，本研究探討出來的手術相關因子與存活率有明顯相關
性，建議國家衛生機關可以明定治療口腔癌的手術標準，以提升口腔
癌的治療品質，延長存活率。

關鍵字

口腔癌 ； 手術危險因子 ； 核心指標

並列摘要

Background:
Oral cancer is one of the top 10 cancer that causes death in Taiwan.
According to 2007 Form Bureau of Health Promotion, the incidence and
mortality of oral cancer remained at the fourth in males since 1997. In
addition, the incidence of oral cancer has shown the most significant
increased among all cancers between 1998 and 2007.
Purpose:
The aim of this study is correlate the collected core indicators from
surgery of oral cancer to the survival analysis and to provide advices to
the national health agencies or other researches.
Methods:
All data of this study were obtained from the Cancer Registry of a
Medical center in the central Taiwan. The parameter is include gender,
age, oral habits (tobacco, alcohol, betel nut), tumor size, location, cervical
lymph node metastases, pathological stage, histological grade, date of
treatment, last contact date and vital status.
Results:
In this study, 239 patients were male (90.5%) and 25 were female
(9.5%); the male-to-female ratio was 9.56: 1. The mean age at diagnosis
was lower in male, which was 49.87±10.4 year old, while the mean age
of female was 56 ± 13.7 year old. Tongue and buccal mucosa were the
most common locations of involvement. The most common histological
type was squamous cell carcinoma(98.9％). With Kaplan-Meier
Analysis, the overall survival rate was 57.046 ± 1.751 months. According
to Cox regression and Log-Rank Test, we found the most important
factors correlated to survival were：perineural invasion, positive lymph
node and neck dissection including more than 10 lymph nodes and tumor
size.
Conclusion:
Although surgery is the gold standard for oral cancer treatment, there
has been no clear standard in surgical practice in our country. Our study
presented the surgery-related core indicators which have significant
influence in survival rate. We hope that our data may provide the national
health authorities to set up a surgical guideline of oral cancer treatment in
order to improve the quality of treatment and the survival rate.

並列關鍵字

Oral cancer, surgical risk factors, core indicators

參考文獻

腔鱗狀細胞癌病患之存活率分析。臺灣耳鼻喉頭頸外科雜誌，43，

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