舌癌Ｔ１・Ｔ２症例の再発因子 臨床病理学的検討

Abstract

Significant factors related to primary recurrence of T1/T2 carcinoma of the tongue and neck lymph node metastasis were analyzed with the use of logistic analysis in 108 patients. All patients had undergone Cot laser resection between March 1980 and April 1997. The factors analyzed included: (1) primary site of the carcinoma, (2) differentiation of squamous cell carcinomas, (3) diameter of the primary tumor, (4) absence/presence of perineural invasion of the primary tumor, (5) absence/presence of intravascular invasion of the primary tumor, (6) absence/presence of in-tramuscular invasion of the primary tumor, (7) depth of primary tumor invasion. (8) surgical margin of the resected primary tumor, and (9) absence/presence of irradiation. Significant risk factors for primary recurrence were a surgical margin of less than 4 mm and tumor coverage of the posterior third of the mobile tongue. A significant risk factor in neck lymph node metastasis was depth of primary tumor invasion of more than 4 mm, no other significant factors for the primary recurrence or regional recurrence were observed. The results suggested that a deep surgical margin of more than 10 mm was nesessary, and that if the primary lesion occupied the posterior third of the mobile tongue, an extended surgical resection was nesessary. In addition, if the depth of the primary tumor invasion is more than 4 mm, preventive modified radical neck dissection is recommended.