查詢結果分析
相關文獻
- The Treatment Outcomes of Surgery-based Salvage for Relapsed Squamous Cell Carcinoma of the Oral Cavity--A Preliminary Study
- Prognostic Factors for Recurrent Oral Carcinoma--A Retrospective Study
- Prolonged Survival of Patient with Recurrent Pulmonary Metastasis from a Primary Adrenal Cortical Carcinoma--A Case Report
- 成人低惡性度顱內星狀細胞瘤之術後放射治療
- Treatment Results of Hodgkin's Disease from 1977 to 1991 in National Taiwan University Hospital
- 十字花科蔬菜黑斑病菌的存活研究
- 以存活分析方法探究臺北市低收入戶生育間隔之影響因素
- Factors Affecting Local or Regional Recurrence in Breast Cancer
- Squamous Cell Carcinoma of the Oral Cavity in Young Patients
- 沒有不良口腔習慣之口腔癌女性患者對於治療預後之探討
頁籤選單縮合
題 名 | The Treatment Outcomes of Surgery-based Salvage for Relapsed Squamous Cell Carcinoma of the Oral Cavity--A Preliminary Study=針對復發之口腔鱗狀上皮細胞癌之救援手術治療成果初步研究 |
---|---|
作 者 | 張起華; 黃怡嘉; 林任芬; 林哲毅; 張敏德; 楊榮武; 蘇偉嘉; 蔣維凡; 張啟華; | 書刊名 | 臺灣口腔顎面外科學會雜誌 |
卷 期 | 27:3 2016.09[民105.09] |
頁 次 | 頁155-166 |
分類號 | 416.954 |
關鍵詞 | 口腔癌; 復發; 無病間隔; 預後因子; 存活; Oral carcinoma; Relapse; Disease-free interval; Early stage; Prognostic factor; Survival; |
語 文 | 英文(English) |
中文摘要 | 目的:腫瘤復發是口腔鱗狀上皮細胞癌病人在治療後最常見之結果,約有25-54%之發生率,發生腫瘤復發之病人通常會有較差之預後。對臨床醫師而言,處理腫瘤復發之極具挑戰且處理方式多元。對於有較佳日常體能狀態與沒有合併症之病人而言,手術為基礎之救援治療仍為最佳之策略。然而,不佳之長期存活率和潛在的手術併發症讓外科醫師在手術進行與否仍面臨極大壓力,本研究目的在於探討重大臨床病理因素以作為手術為基礎之救援治療前的參考依據。材料和方法:本研究針對2008年4月至2014年9月間共86位以手術為初次治療病人且於本醫院進行救援治療之病人群進行回顧性研究,臨床追蹤截止點放設定為2015年12月。存活分析之變項分別為:原發腫瘤與復發腫瘤之臨床病理學因子、首療至復發出現之無病間隔、復發型態等,各因子的存活曲線以Kaplan-Meier進行繪製。獨立預後因子以Cox多重變數分析進行運算,P值小於0.05被設定為有意義。結果:相較於救援性放療/化療,手術為基礎之救援治療呈現明顯較佳的疾病控制且較長的存活期間。在手術為基礎之救援治療的73例病例中,經排除一名手術後30天內死亡病例(死亡率1.8%),共72例進行後績之存活分析與獨立預後因子判定。局部復發是最常見的型態佔76.4%、其次是區域復發佔15.3%、局部合併區域復發有8.3%。2年整體存活率和無病存活率分別為62.4%和35.4%。經救援手術後再發生復發的各種型態分別為:32例(56.1%)局部復發、9例(15.8%)區域復發、13例(22.8%)局部合併區域復發、3例(5.3%)遠處轉移。多重變數分析後呈現無病間隔超過6個月與T1/T2為較佳整體存活之預測因子,無病間隔超過6個月亦為較佳無病存活之預測因子。結論:本初步研究發現較長之無病間隔與早期之復發腫瘤會有較佳預後,並可以手術為基礎之救援治療前之參考因子。 |
英文摘要 | OBJECTIVES: Tumor relapse is the most common outcome in oral squamous cell carcinoma (rOSCC) patients, with a frequency of 25%-54 %, and relapse is usually associated with a poor prognosis. The management of tumor relapse poses a considerable challenge for clinicians; the optimal treatment strategy remains divergent. For patients with a favorable performance status and no comorbidities, surgery-based salvage treatment may be the most promising strategy. However, low survival rates and a potentially high risk of related morbidities represent a considerable challenge in considering treatment options for relapsed rOSCC. The purpose of this study was to determine the significant clinicopathological factors predicting more favorable outcomes in rOSCC patients planning to undertake SAS. MATERIALS AND METHODS: A retrospective study was conducted to review 86 rOSCC patients who had undergone primary curative surgery with or without adjuvant therapy between April 2008 and September 2014. The endpoint of follow-up was set to December 2015. Survival analysis was conducted on the basis of the clinicopathological factors of primary and recurrent tumors, the disease-free interval, and the type of recurrence. Survival curves were plotted using the Kaplan-Meier method, and independent prognostic factors were evaluated using a multivariate Cox proportional hazard regression model. The level of significance for all tests was set at P < 0.05. RESULTS: Compared with salvage chemoradiotherapy, surgery-based salvage treatment was a significant and promising strategy and achieved longer survival and greater improvement in disease control. After excluding one patient who died within 30 days of salvage surgery for an operative mortality of 1.8%, we included 72 patients who received surgery-based salvage treatment in the survival rate estimation and prognostic factor determination. Local relapse was the most common pattern (76.4%), followed by regional (15.3%) and locoregional relapse (8.3%). The 2-year overall survival and disease-free survival rates were 62.4% and 35.4%, respectively. The number of SRS patients who developed a local relapse, regional relapse, locoregional relapse, and distant metastasis as a second relapse was 32 (56.1 %),9 (15.8%), 13 (22.8%), and 3 (5.3%), respectively. The multivariate Cox regression model indicated that a disease-free interval longer than 6 months and early T classification were independent predictors for a longer overaII survival, and a longer disease-free interval was the significant predictor for a longer disease-free survival. CONCLUSIONS: The findings of this preliminary study indicate that a longer disease-free interval and early restage can significantly predict a more favorable outcome in rOSCC patients. These factors should be considered during treatment planning. |
本系統中英文摘要資訊取自各篇刊載內容。