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目的:探讨老年人口腔颌面部肉瘤的临床特点及预后。方法:收集2000—2009年治疗的33例老年人(>60岁)口腔颌面部肉瘤病例进行回顾性分析。利用SPSS12.0软件包进行统计学分析,预后影响因素采用χ2检验。根据随访资料,采用乘积极限法统计生存率。结果:33例患者中,男23例,女10例。平均年龄71岁(61～88岁),平均随访时间21个月(3～83个月)。随访患者29例,失访患者4例,随访率为87.88%。随访患者中,原发病例20例,因肉瘤复发就诊(复发病例)9例。随访病例均经手术治疗,其中单纯手术治疗12例,术后辅助放疗9例,术后辅助放化疗8例。经χ2检验,单纯手术治疗组和术后辅助放化疗组对预后有显著影响(P<0.05)。原发病例中,术后局部复发11例,复发率55%。复发病例中,7例术后出现复发,2例出现远处转移。随访病例中,1年生存率为69%,3年生存率为40.8%,5年生存率为25.4%。单纯手术治疗组和术后联合放化疗组的生存函数采用Logrank检验进行比较,差异具有显著性。结论:手术是治疗老年人口腔颌面部肉瘤的主要手段。根治性手术联合术后放化疗对改善老年肉瘤患者的预后可能有益。
Objective: To investigate the clinical features and prognosis of oral and maxillofacial sarcoma in the elderly. Methods: A retrospective analysis was performed on 33 cases of oral and maxillofacial sarcoma (aged> 60 years) treated from 2000 to 2009. SPSS12.0 software package for statistical analysis, prognostic factors using χ2 test. According to follow-up data, using the product of the limit of survival statistics. Results: Of the 33 patients, 23 were males and 10 were females. The average age was 71 years (range, 61 to 88 years) with an average follow-up of 21 months (range 3 to 83 months). Follow-up of 29 patients, 4 patients were lost to follow-up was 87.88%. Follow-up patients, 20 cases of primary, recurrence of sarcoma (recurrence) in 9 cases. Follow-up cases were treated by surgery, including simple surgery in 12 cases, postoperative adjuvant radiotherapy in 9 cases, adjuvant radiotherapy and chemotherapy in 8 cases. After χ2 test, the prognosis was significantly influenced by surgery alone group and postoperative adjuvant radiotherapy and chemotherapy group (P <0.05). In the primary case, local recurrence occurred in 11 cases, the recurrence rate was 55%. Among the recurrence cases, 7 cases relapsed after surgery and 2 cases had distant metastasis. Follow-up cases, 1-year survival rate was 69%, 3-year survival rate was 40.8%, 5-year survival rate was 25.4%. Survival function of simple surgery group and postoperative radiotherapy and chemotherapy group were compared by Logrank test, the difference was significant. Conclusion: Surgery is the main treatment for oral and maxillofacial sarcoma in the elderly. Radical surgery combined with postoperative radiotherapy and chemotherapy to improve the prognosis of elderly patients with sarcoma may benefit.