Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제37권1호
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  • Pages.15-20
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  • 2011
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
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구강설에 발생한 편평상피세포암의 특성과 치료효과

The characteristics and treatment results of squamous cell carcinomas of oral tongue

  • 김기호 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 최은주 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 김형준 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 남웅 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 차인호 (연세대학교 치과대학 구강악안면외과학교실)
  • Kim, Ki-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Choi, Eun-Joo (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Kim, Hyung-Jun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Nam, Woong (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Cha, In-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • 투고 : 2010.10.10
  • 심사 : 2011.02.09
  • 발행 : 2011.02.28
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초록

Introduction: The characteristics of oral tongue squamous cell carcinomas (SCC) and the treatment results were reviewed to determine the appropriate treatment strategies. Materials and Methods: The medical records of 140 patients diagnosed and treated for oral tongue SCC at Yonsei University Health System from January 1995 to December 2004 were reviewed. For statistic analysis, the survival rate was determined using the Kaplan-Meier method with SPSS version 12.0, and the difference in survival rates was evaluated using a log-rank test. Results: The mean age of the patients with oral tongue SCC patients was 55 (19-85 years old). According to the T, N and pathologic stage, the patients were distributed from a higher to a lower incidence of cases, as follows: T2 (46.4%), T1 (37.9%), T4 (8.5%), and T3 (7.1%); N0 (65%), N1 (20.7%), N2 (13.6%), and N3 (0.7%); and stage I (31.4%), stage II(25.7%), stage IV (22.2%), and stage III (20.7%). Local and regional recurrence and distant metastasis was present in 13.6%, 5% and 4.2% of patients, respectively. The five-year survival rate was 72.2%, and the prognostic factors for oral tongue SCC included neck metastasis, pathologic stage of the disease, cell differentiation, treatment modality, neck dissection as part of the treatment plan, and neck node recurrence. Discussion: It is suggested that ipsilateral neck dissection or bilateral neck dissection should be selected as a treatment of tongue SCC patients with advanced stage.

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참고문헌

  1. Aksu G, Karadeniz A, Saynak M, Fayda M, Kadehci Z, Kocaelli H. Treatment results and prognostic factors in oral tongue cancer: analysis of 80 patients. Int J Oral Maxillofac Surg 2006;35:506-13. https://doi.org/10.1016/j.ijom.2006.01.006
  2. Robbins KT, Medina, JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology- Official report of the academy's committee for head and neck surgery and oncology. Arch Otolaryngol Head Neck Surg 1991;117:601-5. https://doi.org/10.1001/archotol.1991.01870180037007
  3. Lam L, Logan RM, Luke C, Rees GL. Retrospective study of survival and treatment pattern in a cohort of patients with oral and oropharyngeal tongue cancers from 1987 to 2004. Oral Oncol 2007;43:150-8. https://doi.org/10.1016/j.oraloncology.2005.12.030
  4. Gorsky M, Epstein JB, Oakley C, Le ND, Hay J, Stevenson- Moore P. Carcinoma of the tongue: a case series analysis of clinical presentation, risk factors, staging, and outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:546-52. https://doi.org/10.1016/j.tripleo.2003.12.041
  5. El-Husseiny G, Kandil A, Jamshed A, Khafaga Y, Saleem M, Allam A, et al. Squamous cell carcinoma of the oral tongue: an analysis of prognostic factors. Br J Oral Maxillofac Surg 2000; 38:193-9. https://doi.org/10.1054/bjom.1999.0235
  6. Al-Rajhi N, Khafaga Y, El-Husseiny J, Saleem M, Mourad W, Al-Otieschan A, et al. Early stage carcinoma of oral tongue: prognostic factors for local control and survival. Oral Oncol 2000;36:508-14. https://doi.org/10.1016/S1368-8375(00)00042-7
  7. Nason RW, Anderson BJ, Gujrathi DS, Abdoh AA, CAooke RC. retrospective comparison of treatment outcome in the posterior and anterior tongue. Am J Surg 1996;172:665-70. https://doi.org/10.1016/S0002-9610(96)00291-7
  8. Sessions DG, Spector GJ, Lenox J, Haughey B, Chao C, Marks J. Analysis of treatment results for oral tongue cancer. Laryngoscope 2002;112:616-25. https://doi.org/10.1097/00005537-200204000-00005
  9. RJ, Parsons JT, Mendenhall WM, Million RR, Stringer SP, Cassisi NJ. Postoperative irradiation for squamous cell carcinoma of the head and neck: an analysis of treatment results and complications. Int J Radiat Oncol Biol Phys 1989;16:25-36. https://doi.org/10.1016/0360-3016(89)90006-0
  10. Woolgar JA, Rogers SN, Lowe D, Brown JS, Vaughan ED. Cervical lymph node metastasis in oral cancer: the importance of even microscopic extracapsular spread. Oral Oncol 2003;39:130-7. https://doi.org/10.1016/S1368-8375(02)00030-1
  11. Yuen AP, Lam KY, Chan AC, Wei WI, Lam LK, Ho WK, et al. Clinicopathological analysis of elective neck dissection for N0 neck of early oral tongue carcinoma. Am J Surg 1999;177:90-2. https://doi.org/10.1016/S0002-9610(98)00294-3
  12. Kim NK. Prognostic significance of perineural and vascular invasion in oral squamous cell carcinoma [dissertation]. Seoul: Graduate School, Yonsei University; 2010.
  13. Zbaren P, Nuyens M, Caversaccio M, Stauffer E. Elective neck dissection for carcinomas of the oral cavity: occult metastases, neck recurrences, and adjuvant treatment of pathologically positive necks. Am J Surg 2006;191:756-60. https://doi.org/10.1016/j.amjsurg.2006.01.052
  14. Franceschi D, Gupta R, Spiro RH, Shah JP. Improved survival in the treatment of squamous carcinoma of the oral tongue. Am J Surg 1993;166:360-5. https://doi.org/10.1016/S0002-9610(05)80333-2
  15. Schiff BA, Roberts DB, El-Naggar A, Garden AS, Myers JN. Selective vs modified radical neck dissection and postoperative radiotherapy vs observation in the treatment of squamous cell carcinoma of the oral tongue. Arch Otolaryngol Head Neck Surg 2005;131:874-8. https://doi.org/10.1001/archotol.131.10.874
  16. Gonzalez-Garcla R, Naval-Glas L, Sastre-Perez J, Rodrl′guez- Campo FJ, Muñoz-Guerra MF, Usandizaga JL, et al. Contralateral lymph neck node metastasis of primary squamous cell carcinoma of the tongue: a retrospective analytic study of 203 patients. Int J Oral Maxillofac Surg 2007;36:507-13. https://doi.org/10.1016/j.ijom.2007.01.008
  17. Liao CT, Wang HM, Hsieh LL, Chang JT, Ng SH, Hsueh C, et al. Higher distant failure in young age tongue cancer patients. Oral Oncol 2006;42:718-25. https://doi.org/10.1016/j.oraloncology.2005.11.012
  18. Byers RM, Weber RS, Andrews T, McGill D, Kare R, Wolf P. Frequency and therapeutic implications of "skip metastases" in the neck from squamous carcinoma of the oral tongue. Head Neck 1997;19:14-9. https://doi.org/10.1002/(SICI)1097-0347(199701)19:1<14::AID-HED3>3.0.CO;2-Y
  19. Woolgar JA. Histological distribution of cervical lymph node metastases from intraoral/oropharyngeal squamous cell carcinomas. Br J Oral Maxillofac Surg 1999;37:175-80. https://doi.org/10.1054/bjom.1999.0036
  20. Traynor SJ, Cohen JI, Gray J, Andersen PE, Everts EC. Selective neck dissection and the management of the node-positive neck. Am J Surg 1996;172:654-7. https://doi.org/10.1016/S0002-9610(96)00296-6
  21. Kowalski LP, Carvalho AL. Feasibility of supraomohyoid neck dissection in N1 and N2a oral cancer patients. Head Neck 2002; 24:921-4. https://doi.org/10.1002/hed.10127
  22. Andersen PE, Warren F, Spiro J, Burningham A, Wong R, Wax MK, et al. Results of selective neck dissection in management of the node-positive neck. Arch Otolaryngol Head Neck Surg 2002; 128:1180-4. https://doi.org/10.1001/archotol.128.10.1180
  23. Veness MJ, Morgan GJ, Sathiyaseelan Y, Gebski V. Anterior tongue cancer and the incidence of cervical lymph node metastases with increasing tumour thickness: should elective treatment to the neck be standard practice in all patients? ANZ J Surg 2005;75:101-5. https://doi.org/10.1111/j.1445-2197.2005.03306.x
  24. O'Brien CJ, Lauer CS, Fredricks S, Clifford AR, McNeil EB, Bagia JS, et al. Tumor thickness influences prognosis of T1 and T2 oral cavity cancer-but what thickness? Head Neck 2003; 25:937-45. https://doi.org/10.1002/hed.10324