제 3병기 설암에서의 단일 림프절 전이 및 보조 요법
Single Lymph Node Metastasis and Adjuvant Therapy in Stage III Tongue Cancer
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Background and Objectives We analyzed treatment results among stage III oral tonguesquamous cell carcinoma (OTSCC) patients and performed subgroup analyses according tothe depth of invasion (DOI) and node positivity. Subjects and Method We retrospectively analyzed the medical records of 87 stage IIIOTSCC patients. Results A total of 32 recurrences occurred during the study period, eight cases of local re-currence, 12 cases of regional recurrence, eight cases of distant metastasis, and four cases ofloco-regional recurrence. During the study period, 27 patients died due to disease progression. The 5-year recurrence-free survival of the patients was 62.9%, and the 5-year disease-specificsurvival (DSS) was 75.3%. When prognostic factors related to disease recurrence and survivalwere analyzed through univariate and multivariate analyses, only the N classification was sig-nificantly associated with patient survival (hazard ratio 0.36, confidence interval 0.14-0.91). The 5-year DSS of N0 patients was 87.6%, and the 5-year DSS of N1 patients was 63.9%. Among N1 patients, the 5-year DSS was 90.5% when adjuvant therapy was administered and63.9% when adjuvant therapy was not administered, which is a statistically significant differ-ence. We did not observe any difference in treatment outcome or survival between patientswith superficial (DOI ≤10 mm) or deep lesions (DOI >10 mm). Conclusion Among the stage III OTSCC patients, patients with single lymph node (LN) me-tastasis (N1) showed a distinct prognostic difference from other patients (N0), and the adminis-tration of adjuvant therapy to patients having single LN metastasis without other risk factorssignificantly improved their 5-year DSS.
Abstract
Background and Objectives We analyzed treatment results among stage III oral tonguesquamous cell carcinoma (OTSCC) patients and performed subgroup analyses according tothe depth of invasion (DOI) and node positivity. Subjects and Method We retrospectively analyzed the medical records of 87 stage IIIOTSCC patients. Results A total of 32 recurrences occurred during the study period, eight cases of local re-currence, 12 cases of regional recurrence, eight cases of distant metastasis, and four cases ofloco-regional recurrence. During the study period, 27 patients died due to disease progression. The 5-year recurrence-free survival of the patients was 62.9%, and the 5-year disease-specificsurvival (DSS) was 75.3%. When prognostic factors related to disease recurrence and survivalwere analyzed through univariate and multivariate analyses, only the N classification was sig-nificantly associated with patient survival (hazard ratio 0.36, confidence interval 0.14-0.91). The 5-year DSS of N0 patients was 87.6%, and the 5-year DSS of N1 patients was 63.9%. Among N1 patients, the 5-year DSS was 90.5% when adjuvant therapy was administered and63.9% when adjuvant therapy was not administered, which is a statistically significant differ-ence. We did not observe any difference in treatment outcome or survival between patientswith superficial (DOI ≤10 mm) or deep lesions (DOI >10 mm). Conclusion Among the stage III OTSCC patients, patients with single lymph node (LN) me-tastasis (N1) showed a distinct prognostic difference from other patients (N0), and the adminis-tration of adjuvant therapy to patients having single LN metastasis without other risk factorssignificantly improved their 5-year DSS.
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