口腔鱗狀細胞癌術後預後因素之回顧性分析

研究目的：口腔鱗狀細胞癌是男性第四大常見癌症，是台灣最常見的頭頸部鱗狀細胞癌類型。口腔鱗狀細胞的預後因素是多變的且困難治療。本研究回顧分析了口腔鱗狀細胞癌的預後因素。研究方法及資料：回顧2010年至2018年中山醫學大學附設醫院確診為頭頸部鱗狀細胞癌患者1910例，僅納入口腔鱗狀細胞癌且完成根治性切除的患者。排除非口腔鱗狀細胞癌、第二原發癌、未行根治性手術的患者。我們使用Kaplan-Meier統計曲線和Cox風險迴歸分析來探討與總生存率相關的變化。所有統計分析均使用SPSS 22 軟件進行。 研究結果：共有754名口腔鱗狀細胞癌患者符合研究條件。在多變項分析中，年齡≥ 65歲（風險比[HR]：3.146，95% 信賴區間[95% CI]：1.863-5.31，P<0.001），癌症部位為唇（2.040[1.083-3.845]，P=0.027), 腫瘤分化不良(2.040[1.009-4.064], P=0.047)，T3-T4(2.069[1.193-3.589], P=0.010)，N分期(2.093[1.171-3.741], P=0.013)，嗜中性白血球與淋巴性白血球的比值(NLR) ≥ 3 (1.778[1.098-2.878]，P=0.019)，局部復發 (7.446[4.812-11.52]，P<0.001)，或遠端轉移(16.92[8.029-35.67]，P<0.001)是總生存率的獨立預測因子。中位的總生存率為53.78個月。 結論：嗜中性白血球與淋巴性白血球的比值是總生存率的獨立因素。 其他包括年齡、原發腫瘤部位、組織學分化、病理分期、局部復發和遠處轉移也是如此。

Objective：Oral cavity squamous cell carcinoma (OCSCC), the fourth most common cancer among men, is the most common type of head and neck squamous cell carcinoma (HNSCC) in Taiwan. The prognostic factors for this population are variable, and the treatment of OCSCC is a difficult. This study retrospectively analyzed the prognostic factors for OCSCC.Methods and Materials：A total of 1910 HNSCC patients diagnosed at Chung Shan Medical University Hospital were retrospectively reviewed from 2010 to 2018. Only the patients belonged to OCSCC and completed curative resection were included. The patients who were non-oral cavity squamous cell carcinoma, second primary cancer, and without curative surgery were excluded. We used the Kaplan-Meier statistics curve and hazard Cox regression to explore the variation in relation to overall survival (OS). All statistical analyses were performed with SPSS 22 software.Results：A total of 754 patients with OCSCC were eligible for the study. In multivariable analysis, aged ≥ 65 years (hazard ratio [HR]: 3.146, 95% confidence interval [95% CI]: 1.863-5.31, P<0.001), the cancer site of the lip (2.040[1.083-3.845], P=0.027), poorly differentiated tumor (2.040[1.009-4.064], P=0.047), T3-T4 (2.069[1.193-3.589], P=0.010), N+ staging (2.093[1.171-3.741], P=0.013), neutrophil-lymphocyte ratio (NLR) ≥ 3 (1.778[1.098-2.878], P=0.019), local recurrence (7.446[4.812-11.52], P<0.001), or distant metastasis (16.92[8.029-35.67], P<0.001) were independent predictors for OS. Median OS was 53.78 months.Conclusion：NLR was the independent factor for OS. Others, including age, primary tumor site, histological differentiation, pathologic staging, local recurrence, and distant metastasis were also too.