Background: The American Joint Committee on Cancer (AJCC), in its 8th edition, introduces modifications to the previous TNM classification, incorporating tumour depth of invasion (DOI). The aim of this research is to analyse the prognosis (in terms of disease-free survival and overall survival) of clinical early stage (I and II) squamous cell carcinomas of the oral tongue according to the DOI levels established by the AJCC in its latest TNM classification to assess changes to the T category and global staging system and to evaluate the association between DOI and other histological risk factors. Methods: A retrospective longitudinal observational study of a series of cases was designed. All patients were treated with upfront surgery at our institution between 2010 and 2019. The variables of interest were defined and classified into four groups: demographic, clinical, histological and evolutive control. Univariate and multivariate analyses were carried out and survival functions were calculated using the Kaplan–Meier method. Statistical significance was established forpvalues below 0.05. Results: Sixty-one patients were included. The average follow-up time was 47.42 months. Fifteen patients presented a loco-regional relapse (24.59%) and five developed distant disease (8.19%). Twelve patients died (19.67%). Statistically significant differences were observed, with respect to disease-free survival (p= 0.043), but not with respect to overall survival (p= 0.139). A total of 49.1% of the sample upstaged their T category and 29.5% underwent modifications of their global stage. The analysis of the relationship between DOI with other histological variables showed a significant association with the presence of pathological cervical nodes (p= 0.012), perineural invasion (p= 0.004) and tumour differentiation grade (p= 0.034). Multivariate analysis showed association between depth of invasion and perineural invasion. Conclusions: Depth of invasion is a histological risk factor in early clinical stages of oral tongue squamous cell carcinoma. Depth of invasion impacts negatively on patient prognosis, is capable per se of modifying the T category and the global tumour staging, and is associated with the presence of cervical metastatic disease, perineural invasion and tumoural differentiation grade.
背景：美国癌症联合委员会（AJCC）在其第8版中对既往TNM分期系统进行了修订，引入了肿瘤浸润深度（DOI）指标。本研究旨在依据AJCC最新TNM分期标准确立的DOI分级，分析临床早期（I期和II期）舌鳞状细胞癌患者的预后（以无病生存期和总生存期为指标），评估T分期及整体分期系统的变化，并探讨DOI与其他组织学危险因素的相关性。方法：设计回顾性纵向观察性病例系列研究。纳入2010年至2019年间在本机构接受前期手术治疗的所有患者。将研究变量定义并归类为四组：人口统计学特征、临床特征、组织学特征及疾病转归。采用单变量与多变量分析方法，通过Kaplan-Meier法计算生存函数，以p值小于0.05为统计学显著性标准。结果：共纳入61例患者，平均随访时间47.42个月。15例患者出现局部区域复发（24.59%），5例发生远处转移（8.19%），12例患者死亡（19.67%）。统计分析显示无病生存期存在统计学显著差异（p=0.043），但总生存期无显著差异（p=0.139）。49.1%的病例T分期升级，29.5%的病例整体分期发生改变。DOI与其他组织学变量的关联性分析显示，其与颈部淋巴结病理转移（p=0.012）、神经侵犯（p=0.004）及肿瘤分化程度（p=0.034）均存在显著相关性。多变量分析证实浸润深度与神经侵犯具有独立关联性。结论：浸润深度是舌鳞状细胞癌临床早期阶段的组织学危险因素，对患者预后产生负面影响，其本身能够改变T分期及整体肿瘤分期，并与颈部转移性疾病、神经侵犯及肿瘤分化程度存在显著关联。
肿瘤(癌症)患者之家