目的

探讨单纯手术治疗影响舌鳞状细胞癌（TSCC）患者预后的临床病理因素。

方法

选择1996 年1 月至2007 年1 月间在中山大学附属第二医院口腔科首治的，经病理确诊且随访资料完整的单纯手术治疗的TSCC 患者共127 例。应用Kaplan-Meier 法分析生存结果，通过Cox 回归模型确立影响预后的独立因素。

结果

127 例单纯手术治疗的TSCC 患者的平均生存时间为40.19 个月，5 年生存率为52.0%。 单因素分析显示，影响TSCC 患者预后的因素包括年龄、肿瘤部位、肿瘤大小、淋巴结转移、肿瘤临床分期和肿瘤复发等。 多因素分析得出影响预后的独立因素为肿瘤复发。

结论

肿瘤复发为TSCC 预后的独立影响因子；淋巴结转移阴性TSCC 患者单纯手术预后较好，中晚期TSCC 伴淋巴结转移阳性患者单纯手术预后差，需进行综合性序列治疗。

Objective

The effect of chemotherapy and radiotherapy in the comprehensive treatment for tongue squamous cell carcinoma （TSCC） is still not clear enough. The evaluation of the prognostic significance of clinical parameters with the patients undergo radical surgery is necessary.

Methods

127 cases who underwent radical surgery for TSCC only from 1996 January to 2007 January， in the Department of Oral and Maxillaficial Surgery， the Second Affiliated Hospital， Sun Yat-Sen University were collected. The clinical parameters were retrospectively analyzed. Survival analysis was performed using the Kaplan-Meier analysis， comparison among groups was analyzed using log-rank test， and multivariate analysis was conducted using the Cox proportional hazard model. Independent risk factors were deducted.

Results

The mean survival time of the 127 patients was 40.17 months， with five-year survival rates of 52.0%， respectively.Univariate analysis showed that age， part of tongue invasion， cervical lymphatic metastasis， tumor clinical stage， and recurrence were risk factors affecting prognosis （P ＜ 0.05）. Multivariate analysis indicated that recurrence was the independent factor for prognosis.

Conclusions

Recurrence is an independent factor affecting the prognosis. The prognosis of patients who underwent radical surgery is similar with those underwent the comprehensive and sequential treatment of the TSCC without lymphatic metastasis. But the prognosis of patients who underwent radical surgery of the TSCC with lymphatic metastasis is poor， and comprehensive and sequential treatment is necessary for this group of cases.