口腔疾病防治 ›› 2020, Vol. 28 ›› Issue (8): 487-493.DOI: 10.12016/j.issn.2096-1456.2020.08.002

• 专栏论著 • 上一篇    下一篇

单中心24年1 915例口腔鳞癌的临床病理特征和生存分析

陈树伟,杨安奎,张诠,陈文宽,李浩,李秋梨,陈艳峰,陈伟超,杨中元,张星,宋明()   

  1. 中山大学肿瘤防治中心头颈科,华南肿瘤学国家重点实验室,肿瘤医学协同创新中心,广东 广州(510060)
  • 收稿日期:2018-12-07 修回日期:2020-03-28 出版日期:2020-08-20 发布日期:2020-07-15
  • 通讯作者: 宋明
  • 作者简介:陈树伟,主治医师,博士,Email: chenshuw@sysucc.org.cn
  • 基金资助:
    国家自然科学基金项目(81802713);国家自然科学基金项目(81672671)

Analysis of clinicopathological characteristics and survival of 1 915 oral cavity squamous cell carcinoma patients: 24-year experience from a single institution

CHEN Shuwei,YANG Ankui,ZHANG Quan,CHEN Wenkuan,LI Hao,LI Qiuli,CHEN Yanfeng,CHEN Weichao,YANG Zhongyuan,ZHANG Xing,SONG Ming()   

  1. Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
  • Received:2018-12-07 Revised:2020-03-28 Online:2020-08-20 Published:2020-07-15
  • Contact: Ming SONG

摘要:

目的 探讨中国口腔鳞癌患者的临床病理特征和生存率的变化趋势。方法 分析1990~2013年在中山大学肿瘤防治中心接受初次治疗和随访的1 915例口腔鳞癌患者的临床病理特征、分期、治疗模式及5年疾病特异生存率(disease-specific survival, DSS),并分别分析1990~1999年、2000~2009年及2010~2013年3个时期的患者的临床病理特征、分期、治疗模式、5年DSS及其变化趋势。结果 1990~2013年该癌症中心收治的全部口腔鳞癌患者的发病年龄为(54.8 ± 12.6)岁,男女性别比约2:1;舌是口腔鳞癌最好发的部位,占63.6%;Ⅰ-Ⅱ期和Ⅲ-Ⅳ期病例比例相当;治疗模式中以手术为主的治疗方法占80.4%。全部口腔鳞癌的5年DSS为57%;生存率随着年龄增长而下降;女性、非吸烟者、非饮酒者的生存率高于男性、吸烟者、饮酒者;唇、舌、口腔其他部位鳞癌患者的5年生存率分别为81%、63%、42%;接受以手术为主、非手术的治疗方法的患者的5年DSS分别为66%、19%。从变化趋势上看, 1990~1999年与2010~2013年,发病年龄和男女性别比相对稳定;唇和舌鳞癌所占比例逐渐下降,口腔其他部位鳞癌所占比例逐渐上升;治疗模式中以手术为主的治疗方法所占比例从77.7%提高到91.3%;5年DSS从53%逐渐提高至64%,其中女性患者的生存率显著提高,从55%逐渐提高至78%,男性患者的5年DSS则相对基本稳定;接受以手术为主的治疗方法的患者的5年DSS从62%逐渐提高至69%。结论 1990~2013年该癌症中心收治的口腔鳞癌患者的5年DSS稳步提高,尤其是女性患者的生存率显著提高;舌鳞癌患者的生存率达到全球发达国家口腔鳞癌患者的生存率水平;接受以手术为主的治疗方法的患者所占比例及生存率逐渐提高;口腔其他部位鳞癌患者的生存率显著低于唇和舌鳞癌患者,提示今后需进一步加强对口腔其他部位鳞癌的治疗与研究,提高其生存率。

关键词: 癌, 鳞状细胞, 口腔, 舌, 唇, 临床病理特征, 生存, 疾病特异生存率, 治疗模式

Abstract:

Objective To investigate the clinicopathological features and survival rate of oral squamous cell carcinoma patients in China. Methods The clinicopathological characteristics, stage, treatment modality, and 5-year disease-specific survival (DSS) rate of 1 915 OCSCC patients who received initial treatment at the Sun Yat-sen University Cancer Center from 1990 to 2013 were collected and analyzed. The clinicopathological characteristics, stage, treatment modality, and 5-year disease-specific survival (DSS) rate of OCSCC patients treated during the successive decades of 1990-1999, 2000-2009, and 2010-2013 were analyzed retrospectively to show the trends over time. Results The average age of all OCSCC patients who received initial treatment at this cancer center from 1990 to 2013 was 54.8 years (SD, 12.6 years). The sex ratio was approximately 2:1. The oral tongue was the site most prone for OCSCC, accounting for 63.6% of all cases. The proportions of early-stage (Ⅰ-Ⅱ) and advanced-stage (Ⅲ-Ⅳ) cases were approximate. Regarding the treatment modality, surgery-based treatment accounted for 80.4%. Survival analysis showed that the 5-year DSS rate of all cases was 57%. Survival decreased with age. The survival of females, nonsmokers, and nondrinkers was higher than that of males, smokers, and drinkers. The 5-year DSS rates of patients with squamous cell carcinoma of the lips, oral tongue, and other sites of the oral cavity were 81%, 63%, and 42%, respectively. The 5-year DSS rates of patients who received surgery-based treatment and nonsurgical treatment were 66% and 19%, respectively. The analysis of trends over time showed that in the period of 1990-1999 and 2010-2013, the age and sex ratio were relatively stable. The proportion of patients with squamous cell carcinoma of the lips and oral tongue gradually decreased, while the proportion of those with squamous cell carcinoma of the other sites of the oral cavity gradually increased. The proportion of surgery-based treatment increased from 77.7% to 91.3%. The 5-year DSS rate gradually increased from 53% in 1990-1999 to 64% in 2010-2013. The 5-year DSS rate of female patients increased significantly from 55% to 78%. However, the 5-year DSS rate of male patients was relatively stable. The 5-year DSS rate of patients who received surgery-based treatment gradually increased from 62% to 69%. Conclusion The 5-year DSS rate has steadily improved for OCSCC patients at this cancer center from 1990-2013, especially in female patients. The 5-year DSS rate of patients with squamous cell carcinoma of the oral tongue has reached the rate in developed countries worldwide. The proportion and survival rate of patients who received surgery-based treatment gradually increased. The survival rate of patients with squamous cell carcinoma of the other sites of the oral cavity was significantly lower than that of patients with squamous cell carcinoma of the lips and oral tongue, suggesting that more effort should be put into the treatment of patients with squamous cell carcinoma of the other sites of the oral cavity to improve the survival rate in the future.

Key words: cancer, squamous cell, oral cavity, tongue, lip, clinicopathological characteristics, survival, disease-specific survival, treatment modality

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