在口腔腔皮细胞癌中术内边缘评估方法:系统性审查和元分析
John Caraway1, David Millay1, Dominique Zarrella2
1Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
概括
在口腔状细胞癌 (OCSCC) 中基于样本的边缘分析改善了局部控制,并减少了积极边缘. 然而,与基于瘤床的方法相比,它没有显著影响整体复发或生存率.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 头部和部手术 头部和部手术
背景情况:
- 术内边缘分析对于口腔状细胞癌 (OCSCC) 治疗至关重要.
- 在OCSCC中,基于样本的优越性与基于瘤床的边缘分析之间缺乏共识.
研究的目的:
- 进行首次元分析,比较OCSCC中的基于样本和基于瘤病床的手术内边缘评估.
- 为了确定不同的边际分析方法是否会显著影响患者的治疗结果.
主要方法:
- 在PubMed,Embase和Web of Science进行了全面的文献搜索.
- 包括的研究在OCSCC患者中进行了样本驱动和瘤床驱动的边际分析.
- 随机效应的元分析被用来合成9项符合条件的研究 (1240名参与者) 的数据.
主要成果:
- 基于样本的分析显示了更高的再切割率和显著较低的最终积极差额率 (P<.05).
- 与基于瘤床的分析 (P<.05) 相比,在基于样本的分析中观察到局部复发率下降.
- 两种方法之间在总体复发或生存结果方面没有发现显著差异.
结论:
- 在OCSCC中以样本为基础的冷边缘分析导致较低的虚假负率和加强的本地控制.
- 尽管改善了局部控制,但基于样本的与基于瘤床的方法并没有显著改变整体复发或存活率.
- 可能需要进一步的研究来充分阐明长期结果差异.
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