2024-03-28T15:16:39Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:02000554
2022-12-15T04:14:40Z
432:1291:1292:1653965479978
453:456
下顎歯肉扁平上皮癌の臨床的検討
Clinical study of squamous cell carcinoma of the lower gingiva
船山, 昭典
Funayama, Akinori
三上, 俊彦
Mikami, Toshihiko
金丸, 祥平
Kanemaru, Shohei
小田, 陽平
Oda, Yohei
新美, 奏恵
Niimi, Kanae
芳澤, 享子
Yoshizawa, Michiko
新垣, 晋
Shingaki, Susumu
小林, 正治
Kobayashi, Tadaharu
open access
下顎歯肉癌
生存率
再発
下顎骨再建
Squamous cell carcinoma (SCC) of the lower gingiva is the second most common oral cancer in Japan, accounting for about 20% of oral cancers. The treatment result of patients with SCC of the lower gingiva is relatively better than other site of oral cancer. We repot treatment result of the forty-two patients, consisted of 23 men and 19 women, with SCC of the lower gingiva who had presented to our department between January 1995 and December 2008. Thirty-nine patients were treated definitively by surgery with or without chemotherapy and radiotherapy. Twenty-six out of the 39 patients had reconstructed of the mandible with various methods. Eighteen (69.2%) were reconstructed with titanium plates and 6 (23.1%) were free vascularized bone flap. The 5-year disease specific survival rates of T1, 2 (n=23) and T3, 4 (n=19) were 84.6% and 77.2% (P=0.220), respectively, and stage I,II (n=16) and stageⅢ, Ⅳ were 84.4% and 79.1%, respectively (P=0.384). Local recurrence and subsequent cervical lymph node metastasis were observed in ten patients. In all cases with local recurrence, relapse developed in the soft tissue adjacent to the soft-tissue surgical margin. In 9 recurred patients who had performed salvage surgery were carried out, and subsequently, 7 were successfully salvaged. For obtaining the better outcomes, clear soft tissue surgical margins and early detection of local recurrence and subsequent neck metastasis that are in resectable are essential.
本邦において,下顎歯肉癌は口腔癌の中では舌癌に次いでその発生頻度が高く,約20%であり予後は他の口腔癌より比較的良好でとされている。今回,新潟大学医歯学総合病院口腔再建外科を受診した下顎歯肉癌症例の治療結果を報告する。対象は1995年1月から2008年12月(14年間)に当科を初診した下顎歯肉扁平上皮癌1次症例42例(男性23名,女性19名)とした。39例に外科療法を主体に行い,原発巣切除後の下顎再建は,26例に施行されていた。金属プレートを用いた再建が18例(69.2%)で,遊離骨皮弁再建が6例(23.1%)であった。T分類別疾患特異的5年累積生存率はT1+T2(n=23)が84.6%,T3+T4(n=19)が77.2%であった(P=0.220)。臨床病期別ではstageⅠ+Ⅱ(n=16)は84.4%,stageⅢ+Ⅳ(n=26)が79.1%であった(P=0.384)。局所再発と頸部リンパ節後発転移は10例に認められた。また,局所再発はすべて粘膜切除断端付近の軟組織からであった。このうち,9例に手術を施行し,7例が救済可能であった。下顎骨周囲の軟組織の適切な切除範囲の設定と局所再発ならびに頸部リンパ節後転移を手術可能な早期に発見することが重要と考えられた。
新潟歯学会
2016-12
jpn
departmental bulletin paper
VoR
http://hdl.handle.net/10191/0002000554
https://niigata-u.repo.nii.ac.jp/records/2000554
AN00182415
0385-0153
新潟歯学会雑誌
46
2
77
82
https://niigata-u.repo.nii.ac.jp/record/2000554/files/46(2)_77-82.pdf
application/pdf
580KB
2022-05-31