Oral Kavite Kanserlerinde Evreleme, Prognostik Faktörler ve Evreleme Sistemi Üzerine Değerlendirmeler

Oral kavite kanserleri baş boyun kanserleri arasında larinks kanserlerinin ardından ikinci sırada yer alır. Kanser tedavisi planlanırken hastalığın evresi çok önemlidir. Oral kavite kanserleri için halen kullanılan yegane evreleme sistemi TNM sistemidir. Bu sistem tedavi planlaması ve prognoz açısından yol gösterici olsa da bazı eksiklikleri mevcuttur. Özellikle evreleme yapılırken tümör diferansiasyonunun ve tümörün invazyon derinliğinin dikkate alınmamış olması eleştirilebilir bir noktadır. Baş boyun kanserlerinde boyundaki lenf nodu pozitifliğinin prognoz üzerine negatif etkisi tartışılmaz bir gerçektir. Bu makalede tümöre ait bazı faktörlerin boyun lenf nodlarına ve dolayısıyla da prognoza etkisi literatür bilgileri eşliğinde tartışılmaktadır

Oral Kavite Kanserlerinde Evreleme, Prognostik Faktörler ve Evreleme Sistemi Üzerine Değerlendirmeler

Oral cavity cancers are the second most common among the head-neck malignancies following larynx cancers. Staging of cancer is very important during the planning of management. For oral cavity cancers, still the only system used is TNM staging system. Although this system guides us for treatment plan and prognosis, there are some shortages. Neck lymph node involvement has an negative effect on prognosis in head-neck cancer patients. In this article, some factors belonging to tumor affecting neck lymph node involvement and consequently on prognosis are discussed by the review of literature

___

  • Engin K, Erişen L (editör). Baş-boyun kanserleri. 1nci Baskı, Ankara: Nobel Tıp Kitabevi, 2003:235-70.
  • Wingo PA, Bolden S, Tong T, et al.Cancer statistics for 1996;46(2):113-25. CA Cancer J Clin
  • Koç C (editör). Kulak burun boğaz hastalıkları ve baş-boyun cerrahisi. 1nci Baskı, Ankara: Güneş Kitabevi, 2004: 953-64.
  • Cummings WC, Flint WP, Harker AL. Otolaryngology head and neck surgery. 4th Edition, Philadelphia Pennslvania: Elsevier Mosby, 2005:1578-638.
  • Hiratsuka H, Miyakawa A, Nakamori K, et al. Multivariate analysis of occult lymph node metastasis as a prognostic indicator for patients with squamous cell carcinoma of the oral cavity. Cancer 1997;80(3):351-6.
  • Moore C, Kuhns JG, Greenberg RA. Thickness as prognostic aid in upper aerodigestive tract cancer. Arch Surg 1986;121(12):1410-4.
  • Yılmaz T, Ünal F, Saraç F. Dil kanseri: 88 hastanın deneyimi. KBB ve Baş Boyun Dergisi 1999;7(3):213.
  • Uğurluer G. Oral kavite tümörlerinde prognostik faktörlerin ve sağkalımın retrospektif incelenmesi. Uzmanlık Tezi. Ankara: Ankara Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Anabilim Dalı, 2003.
  • Lim YC, Lee JS, Choi EC. Perifacial lymph node metastasis in the submandibular triangle of patients with oral and oropharyngeal squamous cell carcinoma with clinically node-positive neck. Laryngoscope 2006;116(12):2187-90.
  • Shingaki S, Takada M, Sasai K. Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 2003;185(3):278-84.
  • Lindelov B, Kirkegaard J, Hansen HS. Squamous cell carcinoma of the oral cavity. An unselected material from a 5-year period. Acta Oncol 1990;29(8):1011-5.
  • Gallegos-Hernandez JF, Bustos-Colmenars BE, Hernandez-Hernandez DM. Elective neck dissection in oral rongue cancer. Rev Oncol 2004;6(19):41-4.
  • Franceschi D, Gupta R, Spiro RH. Improved survival in the treatment of squamous carcinoma of the oral tongue. Am J Surg 1993;166(4):360-5.
  • Chen YK, Huang HC, Lin LM. Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan. Oral Oncol 1999;35(2):173-9.
  • Ferlito A, Rinaldo A, Devaney KO. Detection of lymph node micrometastases in patients with squamous carcinoma of the head and neck. Eur Arch Otorhinolaryngol 2008;265(10):1147-53.
  • Aygenç E, Özdem C. Dil yassı hücreli kanserlerinde tedavi sonuçlarımız. KBB-forum 2002;1(4):80-5.
  • Sathyan KM, Sailasree R, Jayasurya R. Carcinoma of tongue and the buccal mucosa represent different biological subentities of the oral carcinoma. J Cancer Res Clin Oncol 2006;132(9):601-9.
  • Effiom OA, Adeyemo WL, Omitola OG. Oral squamous cell carcinoma: a clinicopathologic review of 233 cases in Lagos, Nigeria. J Oral Maxillofac Surg 2008;66(8):1595-9.
  • Jin WL, Ye WM, Zheng JW. Occult cervical lymph node metastases in 100 consecutive patients with cN0 tongue cancer. Chin Med J 2008;121(19):1871-4.
  • Kane SV, Gupta M, Kakade AC. Depth of invasion is the most significant histological predictor of subclinical cervical lymph node metastasis in early squamous carcinomas of the oral cavity. Eur J Surg Oncol 2006;32(7):795-803.
  • Clark JR, Naranjo N, Franklin JH. Established prognostic variables in N0 oral carcinoma. Otolaryngol Head Neck Surg 2006;135(5):748-53.
  • Menezes MB, Lehn CN, Gonçalves AJ. Epidemiological and histopathological data and E- cadherin-like prognostic factors in early carcinomas of the tongue and floor of mouth. Oral Oncol 2007;43(7):656-61.
  • Fukano H, Matsuura H, Hasegawa Y. Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma. Head Neck 1997;19(3):205-10.
  • Wallwork BD, Anderson SR, Coman WB. Squamous cell carcinoma of the floor of the mouth: tumour thickness and the rate of cervical metastasis. ANZ J Surg 2007;77(9):761-4.
  • Sano D, Myers JN. Metastasis of squamous cell carcinoma of the oral tongue. Cancer Metastasis Rev 2007;26(3-4):645-62.
  • Hoşal AS, Unal OF, Ayhan A. Possible prognostic value of histopathologic parameters in patients with carcinoma Otorhinolaryngol 1998;255(4):216-9. oral of the tongue. Eur Arch carcinoma. Ann Surg Oncol 2004;11(2):213-8.
  • Bundgaard T, Rossen K, Henriksen SD. Histopathologic parameters in the evaluation of T1 squamous cell carcinomas of the oral cavity. Head Neck 2002;24(7):656-60.