吸烟、饮酒、嚼槟榔对65岁及以上单纯手术治疗的口腔癌患者生存的影响  

The Effects of Smoking,Drinking and Chewing Betel Nuts on the Survival of Oral Cancer Patients Aged 65 Years and Over who Treated only by Surgery

作　　者：朱蕾 钟锐 邱艳芳 单振锋 胡依娜 谢江华 邹艳辉 ZHU Lei;ZHONG Rui;QIU Yan-fang(Hunan University Of Chinese Medicine,Changsha Hunan 410208)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院,湖南长沙410006 [3]湖北省武汉东湖学院,湖北武汉430212 [4]中南大学湘雅医院耳鼻咽喉科,湖南长沙410000

出　　处：《医学临床研究》2023年第6期820-823,共4页Journal of Clinical Research

基　　金：湖南创新型省份建设专项任务(2021ZK4076、2021ZK4078);长沙市科技计划项目(kq1901085)。

摘　　要：【目的】探讨吸烟、饮酒、嚼槟榔对65岁及以上口腔癌单纯手术治疗患者生存的影响。【方法】回顾性分析2013年10月至2021年1月湖南省肿瘤医院收治的单纯手术治疗的65岁及以上口腔癌患者的临床资料,分析其吸烟、饮酒、嚼槟榔情况,并通过电话随访获得患者的生存情况。采用Kaplan-Meier法绘制生存曲线,采用Cox比例风险回归模型分析口腔癌患者单纯手术治疗生存的影响因素。【结果】224例口腔癌患者中位年龄为67.00岁,总中位生存期为85个月,5年生存率为60.3%。单因素生存分析显示,年龄、疼痛、病理分化程度、肿瘤分期、肿瘤直径、侵袭范围是影响65岁及以上口腔癌单纯手术治疗患者生存时间的相关因素(P<0.05)。多因素生存分析显示,年龄>70岁、低分化、肿瘤分期Ⅳ期是影响65岁及以上口腔癌单纯手术治疗患者生存的独立危险因素(均P<0.05)。【结论】吸烟、饮酒、嚼槟榔行为是影响老年单纯手术治疗口腔癌患者生存的独立危险因素,年龄>70岁、低分化、肿瘤分期晚是影响老年口腔癌患者生存的危险因素,当65岁及以上口腔癌患者有淋巴结转移时,手术治疗仍然可能是较好的选择。【Objective】To investigate the effects of smoking,drinking and chewing betel nut on the survival of patients aged 65 years and over with oral cancer who were treated only by surgery.【Methods】The clinical data of oral cancer patients aged 65 years and over who were treated by surgery for the first time in The Hunan Cancer Hospital from October 2013 to January 2021 were retrospectively analyzed.Their smoking,drinking and chewing betel nuts were analyzed,and their survival was obtained through telephone follow-up.Kaplan Meier method was used to draw the survival curve,and Cox proportional hazard regression model was used to analyze the factors affecting the survival of Oral cancer patients after surgery alone.【Results】The median age of 224 patients with oral cancer was 67.00 years old,the total median survival period was 85 months,and the 5-year survival rate was 60.3%.The univariate survival analysis showed that age>70 years old,pain,degree of pathological differentiation,tumor stage,tumor size,invasion range,lymph node metastasis,and the number of lymph node metastasis were the related factors affecting the survival time of patients with Oral cancer who were 65 years old or older after simple surgical treatment(P<0.05).Multivariate survival analysis showed that age,degree of differentiation,and tumor stageⅣwere independent risk factors affecting the survival of patients with Oral cancer who were 65 years old or older after surgery alone(all P<0.05).【Conclusion】Smoking,drinking,chewing betel nut behavior,lymph node metastasis and the number of metastasis are not independent factors affecting the survival of elderly patients with oral cancer treated by surgery alone.Age>70 years old,poor differentiation,and late tumor stage are risk factors affecting the survival of elderly patients with oral cancer.When patients aged 65 years and above have lymph node metastasis,surgical treatment may still be a better choice.

关 键 词：口腔肿瘤/外科学 吸烟 饮酒 槟榔 存活率 

分 类 号：R739.8[医药卫生—肿瘤]