摘要
目的确定口腔鳞状细胞癌(OSCC)患者手术后发生疾病复发的独立危险因素,构建预测复发的回归模型并初步评估。方法回顾性分析2019年于青岛大学附属医院接受根治性手术的OSCC患者的临床及病理资料,并进行术后随访。通过单因素和多因素Cox回归模型分析患者术后复发的危险因素并构建个体预后指数模型,确定最佳截断点,并依此分成低危组和高危组。结果共纳入161例患者,其中男108例、女53例,年龄27~85岁,3年无瘤生存率为63.5%。单因素分析显示身高质量指数、白蛋白、口腔卫生、临床分期、肿瘤分化、脉管癌栓、神经侵犯、T分期、N分期及行术后辅助治疗对预后的影响显著(均P<0.05),年龄、性别、吸烟史、饮酒史、牙列缺失、颈部淋巴结清扫及肌肉浸润对术后复发的影响不显著。多因素分析显示白蛋白水平低、临床分期Ⅳ期、分化程度较差、存在脉管癌栓、术后未行辅助治疗是术后复发的独立危险因素(均P<0.05)。预后指数模型区分的低危组与高危组预后不同(P<0.05),并可以较好地区分患者术后复发的危险程度。结论白蛋白水平、临床分期、分化程度、脉管癌栓及术后辅助治疗与术后复发风险密切相关,是术后复发的独立危险因素。预后指数模型可以为临床工作提供一定参考,注意对高危患者的密切随访,早期发现潜在转移。
Objective To determine the independent risk factors for postoperative disease recurrence in patients with oral squamous cell carcinoma(OSCC),and construct a regression model to predict recurrence and perform preliminary evaluation.Methods The clinical and pathological data of patients with OSCC who received radical surgery in the Affiliated Hospital of Qingdao University in 2019 were analyzed retrospectively,and the postoperative follow-up was conducted.The risk factors associated with postoperative recurrence were analyzed by univariate and multivariate Cox regression models,and the individual prognostic index model was constructed to determine the optimal cut-off point,and the subjects were divided into low-risk group and high-risk group.Results A total of 161 patients were enrolled into this study,including 108 males and 53 females,aged 27-85 years.The 3-year disease-free survival rate was 63.5%.Univariate analysis showed that the height and mass index,albumin status,oral hygiene,clinical stage,degree of tumor differentiation,vascular thrombus,nerve invasion,T stage,N stage,and postoperative adjuvant therapy had significant effects on prognosis of OSCC patients(all P<0.05),while age,sex,smoking history,drinking history,dentition loss,cervical lymph node dissection and muscle infiltration had no significant effects on postoperative recurrence.Multivariate analysis showed that low albumin level,clinical stageⅣ,poor differentiation,presence of vascular cancer thrombus,and no postoperative adjuvant therapy were independent risk factors for postoperative recurrence(all P<0.05).The prognosis was different between the low-risk group and the high-risk group(P<0.05),and the prognostic index model could better distinguish the risk degree of postoperative recurrence of patients.Conclusions Albumin level,clinical stage,differentiation,vascular cancer thrombus and postoperative adjuvant therapy are closely related to the risk of postoperative recurrence and are independent risk factors for postoperative recurrence.The pr
作者
张璐
陆静钰
黄小桐
王荃
陆海军
Zhang Lu;Lu Jingyu;Huang Xiaotong;Wang Quan;Lu Haijun(Department of Oncology and Radiotherapy,Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Radiation Oncology,Beijing Cancer Hospital,Beijing 100143,China)
出处
《中华转移性肿瘤杂志》
2024年第3期207-212,共6页
Chinese Journal of Metastatic Cancer
基金
国家科技部重点研发计划(2022YFC2401505)。
关键词
口腔鳞状细胞癌
预后
预后指数模型
Oral squamous cell carcinoma
Prognosis
Prognostic index model
