淋巴血管浸润是否预测口腔癌的存活率？一项基于人群的分析。
Does lymphovascular invasion predict survival in oral cancer? A population-based analysis.
发表日期：2023 Apr 01
作者：
Julia C Comer, Andrew B Harris, Andrew O Hess, Kathryn E Hitchcock, William M Mendenhall, James E Bates, Peter T Dziegielewski
来源：
ORAL ONCOLOGY
摘要：
评估淋巴血管侵袭作为口腔鳞状细胞癌患者总生存率的独立预测因子。回顾性队列研究。多中心、基于人群的设施报告给国家癌症数据库登记处。访问数据库收集口腔鳞状细胞癌患者的数据。使用多元Cox比例风险模型分析淋巴血管侵袭存在与总生存率之间的关联。符合纳入标准的患者共16,992例，其中3,457例出现淋巴血管侵袭。平均随访时间为32±19个月。淋巴血管侵袭预测了降低的2年总生存率（相对危险度为1.29，95% CI：1.20，1.38，p<0.001）和5年总生存率（相对危险度为1.30，95% CI：1.23，1.39，p<0.001）。淋巴血管侵袭降低了鼻咽癌患者的总生存率（HR：1.27，95% CI：1.17，1.39，p<0.001），口腔底部（HR：1.33，95% CI：1.17，1.52，p<0.001）和颊粘膜（HR：1.44，95% CI：1.15，1.81，p=0.001）的鳞状细胞癌患者的总生存率。接受手术加术后放疗治疗的淋巴血管侵袭患者的生存率明显改善，相比只接受手术的患者（相对危险度为1.79，95% CI：1.58，2.03，p<0.001）与接受手术加术后化疗放疗治疗的患者相比，生存率有所提高（相对危险度为2.0，95% CI：2.26，1.79，p<0.001）。淋巴血管侵袭是口腔鳞状细胞癌的独立重要风险因素，涉及口腔舌、口腔底部和颊粘膜亚位点的总生存率降低。 版权所有©2023 Elsevier Ltd.
To evaluate lymphovascular invasion as an independent predictor for overall survival in patients with oral cavity squamous cell carcinoma.Retrospective cohort study.Multi-center, population-based facilities reporting to the National Cancer Database registry.The database was accessed to collect data on patients with oral cavity squamous cell carcinoma. A multivariate cox proportional hazards model was used to analyze the association between presence of lymphovascular invasion and overall survival.16,992 patients met inclusion criteria. 3,457 patients had lymphovascular invasion. The mean follow-up was 32 ± 19 months. Lymphovascular invasion predicted reduced 2-year overall survival (relative hazard 1.29, 95% CI: 1.20, 1.38, p < 0.001) and 5-year overall survival (relative hazard 1.30, 95% CI: 1.23, 1.39, p < 0.001). LVI reduced overall survival in patients with squamous cell carcinoma of the oral tongue (HR: 1.27, 95% CI: 1.17, 1.39, p < 0.001), floor of mouth (HR: 1.33, 95% CI: 1.17, 1.52, p < 0.001) and buccal mucosa (HR: 1.44, 95% CI: 1.15, 1.81, p = 0.001). Patients with lymphovascular invasion treated with surgery plus post-operative radiotherapy had significantly improved survival compared to those who underwent surgery alone (relative hazard 1.79, 95% CI: 1.58, 2.03, p < 0.001), and patients treated with surgery + post-operative chemoradiotherapy had improved survival compared to those treated with surgery alone (relative hazard 2.0, 95% CI: 2.26, 1.79, p < 0.001).Lymphovascular invasion is an important independent risk factor for decreased overall survival in oral cavity squamous cell carcinoma involving the oral tongue, floor of mouth and buccal mucosa subsites.Copyright © 2023 Elsevier Ltd. All rights reserved.