关键词: 舌鳞状细胞癌, 颈淋巴清扫术, Cox比例风险模型, Cox回归

Abstract:

Objective To analyze the prognostic factors affecting the disease- free survival in T1/T2N0M0- staged patients with squamous cell carcinoma of tongue and compare the effectiveness of different neck treatment modalities. Methods 97 consecutive patients with early- staged squamous cell carcinoma of tongue were included in this study. The treatment and following- up records were reviewed retrospectively. Cox proportional hazard model was used to identify the statistically significant prognostic factors in the 6 potential factors. Kaplan-Meier method was used to estimate the disease - free survival and analyze the survival rate among the different levels, and log- rank method for comparison of the different distribution of the survival. A special focus was on the effectiveness of different neck treatment modalities. Results T stage, treatment methods of primary tumor, the modalities of neck treatment and cell differentiation were statistically significant prognostic factors. The value of P and relative ri（sk RR）were P<0.001, RR=4.387; P=0.04, RR=0.496; P=0.003, RR=0.504; P<0.001, RR=2.620, respectively. The difference of disease- free survival was statistically significant among the different levels under the different factors. Conclusion The disease- free survival was affected by neck treatment modalities remarkably in cN0 stage patients. Selected neck dissection together with adjuvant irradiation could decrease the recurrence risk by 49.6% according to the results of this study. TNM stage system could describe the characteristics of the patients with early- staged squamous cell carcinoma of tongue reasonably.

Key words: squamous cell carcinoma of tongue, neck dissection, Cox proportional hazard model, Cox regression