| To summarize the survival status of tongue squamous cell carcinoma in different age stages and to analyze the influence of various factors on survival and prognosis.Methods: The clinical data of 103 patients with oral tongue squamous cell carcinoma(OTSCC)diagnosed in our hospital from December 2012 to November 2013 were retrospectively summarized.According to the international age range,we selected sex,smoking,chewing areca nut,pain,clinical stage,treatment,pathological grade,recurrence and metastasis as prognostic indicators of oral cancer.Of 103 OTSCC patients,92 were males and 11 were females.The ratio of males to females was 8.36:1.Age ranges from 26 to 71 years.42 cases(40.8%)were younger than 45 years old(including 45 years old),the median age is 43 years old;61 cases(59.2%)were older than 45 years old,the median age is 55 years old.There were 68 patients with smoking history and 35 non-smokers.There were 38 drinkers and 65 non-drinkers.There were 29 people with betel nut chewing history and74 people without betel nut chewing history.There were 42 cases of pain,36 cases of pain and foreign body sensation,23 cases of pain and ulcer,2 cases of difficulty in opening mouth and dysfunction of tongue movement.The stages of T1,T2,T3 and T4 were 2,11,47 and 43 respectively(see Table 2 for details).The stages of N0,N1 and N2 were 39,28 and 36 respectively(see Table 1 for details).According to AJCC standard of the eighth edition,stage I,II,III and IV were 1,7,35 and 60 cases respectively.There were 75 cases of well-differentiated squamous cell carcinoma and 28 cases were moderately or poorly differentiated squamous cell carcinoma.84 patients received surgical treatment alone and 18 patients received adjuvant radiotherapy and chemotherapy after operation.18 patients came to our hospital for treatment again after relapse,including 11 cases of oral recurrence,7 cases of cervical lymph node recurrence,of which 15 cases died and 3 cases survived for 5years after re-treatment.SPSS was used for data analysis,Kaplan-Meier method was used for survival analysis,Chi-square and Fisher exact test were used for each group of single factor analysis,and Cox proportional risk regression model was used for multifactor analysis.Results: The analysis of clinical data showed that male was the dominant group in young patients(< 45 years old)and elderly patients(> 45 years old).The majority of advanced patients(92.8% vs 83.6%)were male.Highly differentiated squamous cell carcinoma was the main pathological grade(76.2% vs 70.5%).The chewing habit of betel nut was more significant in young patients group(P < 0.05).Except for betel nut chewing,there was no difference in the number of patients between the two groups in terms of sex,history of tobacco and alcohol,clinical stage,pathological grade,recurrence and metastasis(P > 0.05).Survival analysis revealed 39 deaths in the whole group,with a 3-year overall survival rate(OS)of 71.8% and a 5-year OS of62.1%.The 3-year overall survival rate and 5-year OS in the youth group were73.8% and 66.7%,respectively.In the elderly group,the 3-year OS was 70.5%,and the 5-year OS was 59.0%.The KM survival curve and COX survival curve showed no significant difference in the overall survival rate between the two groups(P > 0.05),and the KM survival curve showed no statistical difference between the groups after the age was regrouped into three groups and five groups(P > 0.05).In a univariate analysis of all group cases affecting survival outcomes.Smoking history,T stage,N stage,treatment,AJCC stage,pathological grading and recurrence had an impact on survival and prognosis (P < 0.05).Multivariate analysis of COX proportional risk model in the whole group showed that pathological grading and recurrence were independent risk factors affecting the overall prognosis(P < 0.05).In the youth group,chewing history of areca nut,N stage,treatment,pathological grading and recurrence were the risk factors affecting survival and prognosis(P < 0.05),while smoking,T stage,N stage,AJCC stage,treatment,pathological grading and recurrence were the risk factors influencing survival and prognosis(P <0.05).COX risk ratio model in the junior group showed that pathological grading and treatment method were independent risk factors,while COX risk ratio model in the elderly group showed that pathological grading and recurrence were independent risk factors.Conclusion :There was no significant difference in survival and prognosis between young OTSCC patients(< 45 years old)and elderly OTSCC patients(>45 years old);smoking history was a risk factor for survival and prognosis of elderly OTSCC patients;chewing areca nut was a risk factor for survival and prognosis of young OTSCC patients;pathological grading was an independent risk factor for survival and prognosis of OTSCC patients at different age levels,and its influence was not significant.Age limitation is an important prognostic indicator of OTCSS patients.Recurrence and metastasis are independent risk factors affecting the prognosis of elderly patients with OTSCC.The mortality risk of patients with recurrence and metastasis after operation is higher than that of patients without recurrence and metastasis after operation... |
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