口腔へん平上皮癌Ｓｔａｇｅ　Ｉ，ＩＩ手術施行症例の臨床病理学的検討

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  • Clinicopathological study of stage I and II oral squamous cell carcinoma in patients undergoing surgical treatment.

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The purpose of this study was to identify prognostic factors in patients with stage I and II oral squamous cell carcinoma who underwent surgical treatment. Sixty-six patients with newly diagnosed, stage I and II oral squamous cell carcinoma who underwent operation at the First Department of Oral and Maxillofacial Surgery, Kyushu Dental College hospital between 1985 and 1994 were retrospectively analyzed. The clinical factors studied were tumor location, method of excision, prophylactic neck dissection, and method of treatment. The pathological factors studied in biopsy materials were the degree of the differentiation, vessel invasion, tumor depth, YK-classification, and histological malignancy grading as defined by Anneroth (1987). The results are summarized below.<BR>(1) The 5-year cumulative survival rate was 86.8% in stage I and 83.2% in stage II. Nine patients had local recurrence, 3 had postoperative regional lymph node metastasis, and 1 had postoperative distant metastasis. In 11 of these 13 patients (84.6%), symptoms occurred within 14 months.<BR>(2) The local recurrence rate (13.6%, 9/66) was relativery high. However, the rate of regional lymph node metastasis (4.5%, 3/66) was low.<BR>(3) Local recurrence occurred in patients who underwent mandibular marginal resection and had stage II disease, a tumor depth of ≥ 4 mm, and a YK-classification of 4 C or 4 D. There was a significant correlation between outcome and the histological malignancy grade of Anneroth (1987)(step-wise method).

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