切除手術が行われたT4b口腔扁平上皮癌の治療成績に関する多施設共同後ろ向き研究  [in Japanese] A multicenter retrospective study on treatment outcomes of resected T4b oral squamous cell carcinoma  [in Japanese]

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Author(s)

    • 栗田 浩 KURITA Hiroshi
    • 信州大学医学部歯科口腔外科 Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
    • 太田 嘉英 OTA Yoshihide
    • 東海大学医学部外科学系口腔外科学 Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine
    • 桐田 忠昭 KIRITA Tadaaki
    • 奈良県立医科大学医学部口腔外科学講座 Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University
    • 大倉 正也 OKURA Masaya
    • 大阪大学大学院歯学研究科顎口腔疾患制御学講座口腔外科学第一教室 First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University
    • 梅田 正博 UMEDA Masahiro
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences

Abstract

The TNM staging system suggests that advanced oral squamous cell carcinoma (OSCC) with T4b is often unresectable and its outcome is poor. The purpose of this multicenter retrospective study is to assess treatment outcomes of OSCC with T4b. Factors that influence treatment outcome were also analyzed.<br>Clinical and pathological data from 99 consecutive patients with resected T4b OSCC (years from 2000 through 2010) were reviewed and analyzed. The 5-year survival and control rates were the main outcome measures, and prognostic factors were identified by univariate and multivariate analyses.<br>All of the resected T4b tumors involved the masticator space, pterygoid plates, or both without carotid artery encasement and skull base extension. The 5-year overall survival, primary/neck control, and distant metastasis rates were 54.3%, 63.6%, and 18.1%, respectively. Multivariate analysis showed an independent and significant impact of the Eastern Cooperative Oncology Group performance status, mode of tumor invasion, and number/ level of metastatic lymph nodes on overall survival (Cox proportional-hazards model, p<0.01). Postoperative radiotherapy and adjuvant chemotherapy had a marginal impact (p=0.06).<br>The results of this study suggested that T4b OSCC involving only the masticator space, pterygoid plates, or both was resectable and expected to have a favorable outcome. Strategies to overcome highly invasive tumors and multiple lymph node metastases are required.

The TNM staging system suggests that advanced oral squamous cell carcinoma (OSCC) with T4b is often unresectable and its outcome is poor. The purpose of this multicenter retrospective study is to assess treatment outcomes of OSCC with T4b. Factors that influence treatment outcome were also analyzed.<br>Clinical and pathological data from 99 consecutive patients with resected T4b OSCC (years from 2000 through 2010) were reviewed and analyzed. The 5-year survival and control rates were the main outcome measures, and prognostic factors were identified by univariate and multivariate analyses.<br>All of the resected T4b tumors involved the masticator space, pterygoid plates, or both without carotid artery encasement and skull base extension. The 5-year overall survival, primary/neck control, and distant metastasis rates were 54.3%, 63.6%, and 18.1%, respectively. Multivariate analysis showed an independent and significant impact of the Eastern Cooperative Oncology Group performance status, mode of tumor invasion, and number/ level of metastatic lymph nodes on overall survival (Cox proportional-hazards model, p<0.01). Postoperative radiotherapy and adjuvant chemotherapy had a marginal impact (p=0.06).<br>The results of this study suggested that T4b OSCC involving only the masticator space, pterygoid plates, or both was resectable and expected to have a favorable outcome. Strategies to overcome highly invasive tumors and multiple lymph node metastases are required.

Journal

  • Japanese Journal of Oral and Maxillofacial Surgery

    Japanese Journal of Oral and Maxillofacial Surgery 61(1), 3-9, 2015

    Japanese Society of Oral and Maxillofacial Surgeons

Codes

  • NII Article ID (NAID)
    130005097882
  • NII NACSIS-CAT ID (NCID)
    AN00189163
  • Text Lang
    JPN
  • ISSN
    0021-5163
  • NDL Article ID
    026051099
  • NDL Call No.
    Z19-145
  • Data Source
    NDL  J-STAGE 
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