Treatment for squamous cell carcinoma of the floor of the mouth.
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During a period of 22 years, from 1963 to 1984, 45 primary patients with squamous cell carcinoma of the floor of the mouth were treated at the Department of Oral Surgery, Kyusyu University. Of these 45 patients, 38(84.4%) were male.<BR>According to the TNM-classification of the UICC (1978), 9 cases were T1, 23 were T2 and 7 were T3. The other 6 cases were classified T4 because of massive tongue and bone invasion. In stage grouping, 7 cases belonged to stage I, 11 to II, 13 to III and 14 to IV. In 30 cases, the primary lesions of the floor of the mouth arose in the anterior part to bilateral canines, and in 15 cases in the posterior part. In most instances the lesions were ulcerated, and particularly endophytic type with deep ulceration were seen in advanced condition.<BR>In principle, squamous cell carcinomas of the floor of the mouth were treated in our department as follows; In stage I·II cases, interstitial radium therapy or resection only was performed. Stage III·IV cases received surgical treatment combined with preoperative external radiaton and bleomycin. When the primary lesion was controlled by this combined therapy radiation and bleomycin, surgery was not performed. Five cases of 7 in T3 category were treated only with this combined therapy without surgical treatment.<BR>The reconstruction of oral cavity after en bloc operation were performed with cervical island skin flap in most T2 cases, and segmental mandiblectomy or subtotal glossectomy was followed by the reconstruction with Pectoralis Major Myocutaneous flap.<BR>Of 6 recurrent cases, 4 patients died of primary lesion recurrence, one died of other illness and one is alive. Metastasis to the cervical lymph nodes were histologically confirmed in 15 cases. Secondary and bilateral metastasis was noted in 5 and 4 cases respectively.<BR>The survival rate in all cases was 61.9% by 5 years (T1, 63.7%; T2, 65.2%; T3, 71.3%; T4, 42.8%), 5 years survival rate was 67.4% in cases treated by interstitial radium therapy, 63.2% by combined therapy of radiation and bleomycin, 62.2% by surgery combined with preoperative radiation and bleomycin. The survival rate was significantly higher in cases without metastasis (78.6%) compared with cases with metastasis (38.6%).
- 社団法人 日本口腔外科学会の論文
社団法人 日本口腔外科学会 | 論文
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