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Taiwan Journal of Oral Medicine Sciences

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篇名 男性頰黏膜鱗狀細胞癌(BMSCC)患者接受治療的預後探討
卷期 24:2
並列篇名 The Prognosis of Male Buccal Squamous Cell Carcinoma Patients after Treatment
作者 張弘霖何佩珊楊奕馨陳中和
頁次 105-118
關鍵字 頰癌治療預後Squamous cell carcinoma of buccal mucosaSurgeryPrognosis
出刊日期 200808

中文摘要

研究目的:本研究目的欲了解男性頰黏膜鱗狀細胞癌(BMSCC)患者接受治療的預後的情形。
材料與方法:回溯分析高雄醫學大學附設中和紀念醫院口腔顎面外科門診,男性頰黏膜鱗狀細胞癌(BMSCC)接受治療的病患共有125位。自1990年5月至1996年12月間有18人,自1997年1月至2001年間有54人,自2002年1月至2006年7月間53人,進行病歷回顧登錄病患資料並分析之。
結果:平均追蹤52.3月,復發率為18.4%,一至三年的無病存活率分別為82.4%、63.9%、61.2%、53.0%、50.9%、46.3%,臨床病理特徵與無病存活率的關係,經Kaplan-Meier estimates 和Log Rank Test 中發現年齡、腫瘤大小、臨床分期、頸部淋巴轉移、切除頰皮膚會影響無病存活率在統計學上達顯著性差異。經Proportional Hazards Model單變項分析,結果在年齡、腫瘤大小、臨床分期、頸部淋巴轉移和切除頰皮膚都與無病存活率的關係達到顯著性差異,再將年齡、臨床分期、頸部淋巴轉移、切除頰皮膚和治療方式加以調整,結果只有年齡、臨床分期是與無病存活率的關係達到顯著性差異,年齡55歲以上是比年齡45以下有3.46倍的復發危險性,臨床分期在末期病人是比初期病人有4.87倍的復發危險性。
結論:切除頰皮膚與無病存活率的關係,結果在不管是否切除皮膚,末期病人傾向預後較差的,所以早期篩檢及早期治療仍然是很重要的,頰癌病患接受治療後到半年,半年到一年是復發的高峰期,所以應加強衛教病患這段時間返院複診。

英文摘要

Purpose:
The purpose of this study was to investigate the prognosis of male patients with the buccal squamous cell carcinoma receiving surgical treatment combine with /without radiotherapy or chemotherapy.
Subjects and Methodology:
A total of 125 male patients were included of whom18 patients collected from May 1990 to December 1996,54 patients collected from January 1997 to December 2001 and 53 patients collected from January 2002 to July 2006. The clinical details were extracted from the computerised records and case records of the department of oral maxillofacial surgery, Chung-Ho Memorial Hospital, Kaohsiung, Taiwan. The disease-free survival was analysed by the
Kaplan-Meier estimates, and the differences in survival was compared using the Log Rank test.
The Cox proportional hazard model identified the prognostic factors of local recurrent rate and disease-free survival.
Results:
The local recurrent rate was 18.4%, the 0.5, 1, 1.5, 2, 2.5 and 3-year disease-free survival probability was 81.6%、63.9%、61.2%、53.0%、50.9%、46.3% respectively. The Kaplan-Meier estimates and Log Rank test found that age, tumor size, clinical stage, lymph node metastases and cheek skin excision were significant prognostic factors of disease-free survival The Cox proportional hazard model using univariate analysis.We found that age, tumor size,clinical stage, lymph node metastases and cheek skin excision were significantly affecting disease-free survival. We had adjusted age, clinical stage, lymph node metastases, cheek skin excision and treatment modalities. The age and clinical stage were major prognostic factor of the disease-free survival. The recurrent rate was 3.46 times higher patients those over 55 years old than under 45 years old.The recurrent rate was 4.87 times higher patients in the advanced stage than those in early stage.
Conclusion:
Whether received skin excision or not, patients in advanced stage had poor prognosis than those in early stage. Early screening and treatment is very importment.The cancer recurrence may be detected within 6 mouths and between the half year and first year after operation.Therefore,it is necessary to have close follow-up in this period.

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