| Abstract | The aim of this study was to evaluate the preoperative effects of reduced blood oxygen carrying capacity (anemia) on the risk of regional metastases/second primary tumor occurrence in patients with early stage (T1-T2N0M0) oral squamous cell carcinoma (OSCC) after primary surgical treatment.
Methods: Candidates for inclusion were consecutive patients with OSCC referred to the respective institutions (UH Dubrava and UCCK) between 1 January 2000 and 31 December 2010, meeting the following criteria: 1) adults >18 years of age; 2) verified T1-T2N0M0 stage; 3) available data on clinical and laboratory work-up allowing for assessment of demographics, life-style/habits, anemia, and comorbidity. Patients with concurrent malignancy were not included. The inclusion time-frame allowed for the longest
potential censored observation was 15 years and the shortest censored observation was 5 years (patients treated by the end of 2010). Occurrence of regional metastases and second primary tumors were verified based on clinical, radiological, and histopathological data. Binary logistic regression was used to investigate the effect of “anemia” and “anemia types” after adjusting for other risk factors.
Results: In this study, we included 304 patients with early stage OSCC, mean age was 59.5±11.0, and 79% of the patients were male. Regional metastases were identified in 100 (32.9%) patients, and second primary tumors in 40 (13.2%) patients. Microcytic anemia was significantly associated with higher risk of regional metastases (71.4% vs. 28.5%, p=0.002), with an OR of 5.18 (95% CI 1.52 to 17.2, p=0.009). Alcohol consumption was independently associated with an increased risk of second primary tumors with an OR of 2.78 (95% CI 1.01 to 7.63, p=0.04).
Conclusions: In patients with OSCC, microcytic anemia was an independent predictor of regional metastases, and alcohol consumption was an independent predictor of second primary tumor. Patients with second primary tumors tend to be of older age. |
| Abstract (croatian) | Cilj ovog istraživanja bio je procijeniti značaj smanjenja prijeoperativnog kapaciteta oksigenacije krvi (anemija) na pojavu regionalnih metastaza i drugih primarnih tumora u bolesnika s ranim stadijem planocelularnog karcinoma usne šupljine nakon primarnog kirurškog liječenja. Kandidati za uključivanje u istraživanje bili su konsekutivni bolesnici s planocelularnim karcinomom usne šupljine iz dvije institucije (KB Dubrava i KBC Kosovo), koji su bili liječeni u razdoblju od 1. siječnja 2000.
do 31. prosinca 2010. i koji su zadovoljavali sljedeće kriterije: 1. stariji od 18 godina; 2. dokazani T1- T2N0M0 stadiji bolesti; 3. prisutni podaci o kliničkim i laboratorijskim parametrima koji omogućuju procjenu, kao i demografski podaci o stilu života i navikama, anemiji i komorbiditetu. Bolesnici s multiplim primarnim tumorima i bolesnici koji su ranije liječeni zbog tumora u području glave i vrata bili su isključeni iz istraživanja. Vrijeme praćenja bolesnika uključivalo je vremenski okvir od najdužeg potencijalnog cenzuriranog promatranja od 15 godina do najkraćeg cenzuriranog promatranja od 5 godina (bolesnici
liječeni do kraja 2010. godine). Pojava regionalne metastaze ili drugog primarnog tumora bila je dokazana na temelju kliničkog pregleda, radiološki i patohistološki. Binarna logistička regresija bila je upotrijebljena da se istraži učinak anemije i
tipova anemije nakon prilagođavanja za druge faktore rizika.
Rezultati: u ovoj studiji uključili smo 304 pacijenata koji su bili u ranom stadiju OSCC, srednje dobi 59,5±11,0 godina, a 79% pacijenata bilo je muškog spola. Regionalne metastaze bile su identificirane u 100 (32,9%) pacijenata, a sekundarni primarni tumori u 40 (13,2%) pacijenata. Mikrocitna anemija bila je značajno povezana s većim rizikom od regionalnih metastaza (71,4% vs. 28,5%, p=0,002), s OR od 5,18 (95% CL 1,52 do 17,2, p=0,009). Konzumacija alkohola bila je nezavisno povezana s povećanjem rizika od sekundarnih primarnih tumora s OR od 2,78 (95% CL 1,01 do 7,63, p=0,04).
Zaključak: Kod pacijenata s OSCC mikrocitna anemija bila je nezavisni prediktor regionalnih metastaza, a konzumacija alkohola je bila nezavisni prediktor za sekundarne primarne tumore. Pacijenti sa sekundarnim primarnim tumorima obično su starije dobi. |
