Standardized and individualized diagnosis and treatment of oral squamous cell carcinoma: opportunities and challenges

doi:10.7518/hxkq.2020.05.002

Abstract

Abstract:

How to improve the effects of treatment on patients with oral squamous cell carcinoma (OSCC) has always been the focus of clinical and basic studies. The standardized diagnosis and treatment of malignant tumors aim to improve the effects of treatment, and individualized treatment based on standardized diagnosis and treatment may further improve these effects. On the basis of the existing guidelines for the diagnosis and treatment of patients with OSCC, this study explored the opportunities and challenges of standardized and individualized diagnosis and treatment of OSCC. These challenges and opportunities were related to the updates of clinical and pathological staging system, surgical margins, and neck dissection in patients with OSCC at early stage and preoperative induction therapy and postoperative adjuvant treatment in patients with advanced OSCC. This study also shared ideas on clinical studies of OSCC to optimize the existing treatment schemes, improve the treatment effects, and enhance the guidelines.

Key words: oral squamous cell carcinoma, standardized diagnosis and treatment, individualized treatment

CLC Number:

R782

Zhong Laiping. Standardized and individualized diagnosis and treatment of oral squamous cell carcinoma: opportunities and challenges[J]. West China Journal of Stomatology, 2020, 38(5): 484-488.

Figures/Tables 2

Tab 1

The eighth edition AJCC TNM staging criteria for oral cancer

分期			标准
T分期	TX		原发肿瘤不能评估
	Tis		原位癌
	T1		肿瘤最大径≤2 cm,DOI≤5 mm
	T2		肿瘤最大径≤2 cm,5 mm<DOI≤10 mm,或者2 cm<肿瘤最大径≤4 cm且DOI≤10 mm
	T3		肿瘤最大径>4 cm,或者任何肿瘤DOI>10 mm
	T4		中等晚期或非常晚期的局部病变（注：侵犯浅表骨/牙槽窝的牙龈原发肿瘤不足以将其分类至T4）
		T4a	中等晚期局部病变
			（唇）肿瘤侵犯穿透皮质骨或累及下牙槽神经、口底或面部皮肤（如颏部或鼻）
			（口腔）肿瘤仅侵犯邻近结构（如穿透下颌骨或上颌骨的皮质骨,或累及上颌窦或面部皮肤）
		T4b	非常晚期局部病变
			肿瘤侵犯咀嚼肌间隙、翼板或颅底和/或包绕颈内动脉
临床N分	NX		区域淋巴结不能评估
期（cN）	N0		无区域淋巴结转移
	N1		同侧单个淋巴结转移,最大径≤3 cm,ENE（-）
	N2		同侧单个淋巴结转移,3 cm<最大径≤6 cm,ENE（-）;或同侧多个淋巴结转移,最大径≤6 cm,ENE（-）;或双
			侧或对侧淋巴结转移,最大径≤6 cm,ENE（-）
		N2a	同侧单个淋巴结转移,3 cm<最大径≤6 cm,ENE（-）
		N2b	同侧多个淋巴结转移,最大径≤6 cm,ENE（-）
		N2c	双侧或对侧淋巴结转移,最大径≤6 cm,ENE（-）
	N3		转移淋巴结最大径>6 cm,ENE（-）;或转移淋巴结临床明显ENE（+）
		N3a	转移淋巴结最大径>6 cm,ENE（-）
		N3b	转移淋巴结临床明显ENE（+）
病理N分	NX		区域淋巴结不能评估
期（pN）	N0		无区域淋巴结转移
	N1		同侧单个淋巴结转移,最大径≤3 cm,ENE（-）
	N2		同侧单个淋巴结转移,最大径≤3 cm,ENE（+）;或3 cm<最大径≤6 cm,ENE（-）;或同侧多个淋巴结转移,最
			大径≤6 cm,ENE（-）;或双侧或对侧淋巴结转移,最大径≤6 cm,ENE（-）
		N2a	同侧或对侧单个淋巴结转移,最大径≤3 cm,ENE（+）;或同侧单个淋巴结转移,3 cm<最大径≤6 cm,ENE（-）
		N2b	同侧多个淋巴结转移,最大径≤6 cm,ENE（-）
		N2c	双侧或对侧淋巴结转移,最大径≤6 cm,ENE（-）
	N3		转移淋巴结最大径>6 cm,ENE（-）;或同侧单个淋巴结转移,最大径>3 cm,ENE（+）;或同侧、对侧或双侧多
			个淋巴结转移,任意一个ENE（+）
		N3a	转移淋巴结最大径6 cm,ENE（-）
		N3b	同侧单个淋巴结转移,最大径>3 cm,ENE（+）;同侧、对侧或双侧多个淋巴结转移,任意一个ENE（+）
远处转移	M0		无远处转移
（M）	M1		有远处转移

Tab 1

Tab 2

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