经口机器人手术治疗舌根恶性肿瘤的多中心研究及疗效分析  

Multicenter study on the efficacy of transoral robotic surgery for malignant tongue base tumors

作　　者：宋明[1] 徐成志 徐凯[3] 梁发雅[4] 杨会军[5] 吴春萍 陈树伟[1] 蔡兰军 韩萍[4] 楚龙娟 何长顶 张星[1] 周梁 王琰[5] 黄晓明[4] 陆翔 杨安奎[1] 陶磊 Song Ming;Xu Chengzhi;Xu Kai;Liang Faya;Yang Huijun;Wu Chunping;Chen Shuwei;Cai Lanjun;Han Ping;Chu Longjuan;He Changding;Zhang Xing;Zhou Liang;Wang Yan;Huang Xiaoming;Lu Xiang;Yang Ankui;Tao Lei(Department of Head and Neck Surgery,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Otolaryngology Head and Neck Surgery,Eye&ENT Hospital,Fudan University,Shanghai 200031,China;Department of Otorhinolaryngology Head and Neck Surgery,Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430030,China;Department of Otorhinolaryngology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510280,China;Department of Otorhinolarygology,The First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中山大学肿瘤防治中心头颈科,广州510060 [2]复旦大学附属眼耳鼻喉科医院耳鼻咽喉头颈外科,上海200031 [3]华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科,武汉430030 [4]中山大学孙逸仙纪念医院耳鼻咽喉科,广州510280 [5]中国医科大学附属第一医院耳鼻咽喉科,沈阳110001

出　　处：《中华耳鼻咽喉头颈外科杂志》2025年第3期278-284,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的评估经口机器人手术(TORS)在舌根恶性肿瘤治疗中的临床疗效。方法收集并分析2017年1月至2023年1月间在复旦大学附属眼耳鼻喉科医院、中山大学肿瘤防治中心、华中科技大学同济医学院附属同济医院、中山大学孙逸仙纪念医院和中国医科大学附属第一医院五个中心接受TORS治疗的49例舌根恶性肿瘤患者的临床资料,男性38例,女性11例,年龄(59.0±8.8)岁。比较患者的基线资料、并发症及随访情况。采用独立样本t检验或Mann-Whitney U检验比较连续变量;分类变量采用卡方检验或Fisher精确检验分析组间差异;生存分析采用Kaplan-Meier法计算总生存率和无病生存率,组间差异通过Log-rank检验比较。结果病理为鳞状细胞癌(鳞癌)者41例(占83.7%),其中p16阳性表达率为51.2%(21/41)。舌根鳞癌p16阳性组(n=21)与阴性组(n=20)在年龄、性别、术后出血等方面差异无统计学意义(P值均>0.05),但在TNM分期上差异有统计学意义(χ^(2)=14.556,P=0.020),p16阳性组以Ⅰ期为主(66.7%),p16阴性组以Ⅲ、Ⅳ期为主(分别为40.0%和30.0%)。术后气管切开率为30.6%(15/49),术后出血发生率为6.1%(3/49)。49例患者的1年和3年总生存率为98.0%和92.5%,无进展生存率为89.2%和84.9%。p16阳性组与阴性组的3年总生存率(100%比83.8%,χ^(2)=1.093,P=0.518)和3年无病生存率(68.2%比88.9%,χ^(2)=2.161,P=0.382)差异无统计学意义。结论TORS治疗舌根恶性肿瘤具有较高的临床安全性和良好的肿瘤学疗效。ObjectiveTo evaluate the clinical efficacy of transoral robotic surgery(TORS)in the treatment of malignant tongue base tumors.MethodsA multicenter study was conducted to collect and analyze the clinical data of patients with malignant tongue base tumors who underwent TORS at five otolaryngology-head and neck surgery centers in China,including Eye Ear Nose and Throat Hospital of Fudan University,Sun Yat-sen University Cancer Center,Tongji Hospital of Huazhong University of Science and Technology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,and the First Affiliated Hospital of China Medical University between January 2017 and January 2023.Among the patients,38 were males and 11 were females,with a mean age of 59.0±8.8 years.Baseline characteristics,complications,and follow-up data were compared between groups.Independent sample t-tests or Mann-Whitney U tests was used for comparisons of continuous variables;chi-square tests or Fisher′s exact tests was applied for categorical variables.Survival analysis was performed using the Kaplan-Meier method to calculate overall survival and disease-free survival,and differences between groups were compared using the log-rank test.ResultsAmong the 49 patients,41(83.7%)were diagnosed with squamous cell carcinoma(SCC),with a p16 positive rate of 51.2%(21/41).There were no statistically significant differences between the p16-positive group(n=21)and the p16-negative group(n=20)in age,sex,or postoperative bleeding(all P>0.05).However,there was a significant difference in TNM stage between the two groups(χ^(2)=14.556,P=0.020),with the p16-positive group predominantly in stage I(66.7%)and the p16-negative group primarily in stagesⅢandⅣ(40.0%and 30.0%,respectively).The postoperative tracheotomy rate was 30.6%(15/49),and the incidence of postoperative bleeding was 6.1%(3/49).The 1-year and 3-year overall survival rates were 98.0%and 92.5%,respectively,while,the 1-year and 3-year disease-free survival rates were 89.2%and 84.9%,respectively.No significant differences w

关 键 词：头颈部肿瘤 舌根恶性肿瘤 经口机器人手术 生存预后 术后并发症 

分 类 号：R739.8[医药卫生—肿瘤]