J Meikai Dent Med 0, 7 79, 0 7 0 5 0 5 0 5. 0 5 8.5 5 7. Stage 8.0Stage 78.7Stage 5.Stage.8 Clinical Pathological Study of Malignant Neoplasm on 5 Cases in Our Department for past 0 years Katsuyuki INOUE, Yoshito OHYAMA, Yukihiro KAWAMOTO, Shota TAKIZAWA, Yuka OKU, Eri OKAMOTO, Masakatsu FUKUDA, Hisao SHIGEMATSU, Osamu AMANO, Kentaro KIKUCHI, Kaoru KUSAMA, Seiji SUZUKI, and Hideaki SAKASHITA Division of Oral and Maxillofacial Surgery, Department of Diagnostic & Therapeutic Sciences, Meikai University School of Dentistry Divison of Anatomy, Department of Human Development & Fostering, Meikai University School of Dentistry Division of Pathology, Department of Diagnostic & Therapeutic Sciences, Meikai University School of Dentistry Abstract : The aim of this retrospective study was to investigate the situation of patients with malignant neoplasms in the oral and maxillofacial region who had been treated at the Second Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University Hospital, during the last 0 years970 to 00. A total of 5 consecutive patients were included in the study, comprising males and 0 females, with a mean age of 5. yearsrange, to 0 years. The tongue was the most common subsite affected, followed in order by the mandibular gingiva and maxillary gingiva. Among the 5 cases of carcinoma, the pathological diagnosis was squamous cell carcinoma in 8.5. The five-year overall survival rate was 7.. The results according to stage were : stage I 8.0, stage II 78.7, stage III 5., and stage IV.8. Because of the
7 0, 0 increased tendency for oral malignant neoplasm in elderly patients, it is important to consider the age, general condition and complications of such patients when devising a treatment strategy. The survival rate of patients decreased as the tumor stage advanced. Therefore, our present data reconfirm the importance of early diagnosis and treatment to save patients with malignant neoplasms. Key words : malignant neoplasms, clinical pathological study, maxillafacial region, survival rate 970 5 5 7 7 00 0 0 5 5 000 TNM Stage 005 WHO TNM Stage 00 997 UICC 00 UICC Stage 5 Kaplan-Meier 0 97980 98990 99000 0000 50-08 -.5 005 5. 7..8. Fig 57. 0.. : 0 0 9.5 70.50 9.9 5. 70. Figs, 55.8.7. 7. 0.7 9 7. 59 0.7 8. 9 7. 7.9 5.5.0 9.7 8.5. 5 0.9 7 58.7
悪性腫瘍 5 例の臨床病理学的検討 75 Fig Number of patients during 0 years from 970 to 00 Fig Ratio of male to female Fig Fig Age distribution Distribution of head and neck regions 各 例であった 経年的に比較すると 期 期の全期において 舌 が最も多く 期のみは舌 上顎歯肉 上顎洞の順であ ったが,, 期ではすべて舌 下顎歯肉 上顎歯肉の 順で多かった Fig Fig 5 Histopathological type SCC : squamous cell carcinoma, ML : malignant lymphoma ACC : adenoid cystic carcinoma, UDC : undifferentiated carcinoma MM : malignant melanoma, AC : adenocarcinoma MUC : mucoepidermoid carcinoma, LEU : Leucemia OTH : others *Expect of Polymorphous low-grade adenocarcinoma
7 井上勝元 大山嘉人 川本幸寛ほか 明海歯学 0, 0 Fig 8 Fig Stage grouping TNM staging T C : Chemotherapy Fig 7 TNM staging N Fig 9 R : Radiation S : Surgery Initial treatment ④病理組織型 組織型では扁平上皮癌が 5 例 8.5 と大部分を 占め 次いで悪性リンパ腫 例.8 腺様嚢胞癌 例.7 未分化癌 8 例. 悪性黒色腫 例. 腺癌 例. 粘表皮癌 5 例 0.9 白 血病 例 0. の順であった 組織型が 例に満た ないものに関しては その他として一括してあつかっ た その内訳は乳頭癌 多形低悪性度腺癌 粘液腺癌 肝細胞癌 骨髄腫 血管内皮腫 エナメル上皮線維肉 腫 悪性線維性組織球症 横紋筋肉腫 平滑筋肉腫 肉 腫 組織型の不確定なもの であった なお 亜型の疣 贅癌や紡錘細胞癌も扁平上皮癌として扱った 腺癌については肺および胆嚢からの転移性癌をそれぞ れ 例ずつ認めた Fig 0 Survival rate 97 005 転移性癌は 8 例あり 肺 例 胃 例 肝 甲状腺 胆嚢に各 例ずつみられた 口腔内多発癌は 例あり 扁平上皮癌 5 例と未分化癌 例であった 転移性癌や口 腔内多発癌は近年増加傾向を認めた 経年的比較においても 期のすべてで 扁平上皮 癌が約 8 割を占めた Fig 5 ⑤TNM 分類 次症例 非上皮性腫瘍例 造血性悪性腫瘍を除く 次 症 例 79 例 に つ い て ま ず T 分 類 で は T 70 例 5.5 T 5 例. T 9 例 0.0 T59 例. の順であった N 分類では N0 9 例 70.8 N 7 例.8 N 5 例.7 N 例.7 の順であり リンパ節転移と診断された N N
5 77 Table stage stage stage stage Stage grouping divided into decade after decade 97 980 98 990 99 000 00 00 Total 5 7 0 0 5 0 0 80 7 5 87 8 9 80 0 Total 7 08 7 7 *Expect of defy stage classification Table C R S C-R C-S R-S C-R-S Initial treatment of oral SCC *according to stage stage stage stage stage Total 7 50 5 7 5 7 8 9 5 0 Total 00 95 98 5 9 5 5 7 7 C : Chemotherapy R : Radiation S : Surgery *Including major salivary gland neoplasm, maxillary sinus carcinoma 0 9.M M0 9.M 8.8 7 T 7.7 7...7 Figs, 7 Stage Stage 79 Stage0 9.Stage0 9. Stage9.8Stage80.7 StageStage A, 87 8.StageB, 7 7.8Stage C,.Stage 5.9 Stage Stage 5. 5. 5.555. Fig 8, Table 8.0 78 9.0 5.7 0.0 7. 5..7 80.7..8.8 50.0 Fig 9, Table 97 005 9 5 0 Stage 5 Kaplan-Meier Stage 8.0Stage 78.7Stage 5.Stage.8 5 7. Fig 0 5, 0 70 5., 5, 8 70. 70. 70 7. 70 7. 70.. :, 5, 8, 9. :.9 :
78 0, 0 58, 5, 8, 9 5.9, 5, 8, 9 8.. 8.5.9 CT 8.5, 5, 8, 9.8 T T5 7.T0 8.9T85 0.5T5.0 T, 5, 8, 9 N N0 70.8 T T 7.T 8.8T.T 55. T T T cm earlyt cm latet Stage Stage 5.9 Stage Stage 5. 5. 5.5 55. 80.7 7 990 000 S- Tumore Dormancy TherapyTDT 0 Stage Stage Stage Concurrent Chemoradiotherapy : CCRT S- TDT 5 Stage QOL Stage StageStage 5 000
5 79 TNM Stage Stage StageStage 000 0 0, 9, 00 In pp8 5, 00 7 0, 550 557, 00 0, 9, 987, 9, 007 0 5, 7, 00 0 9, 7 7, 00 58, 7 7, 008 0 0, 5 0, 008 Tumor dormancy therapy 98, 7 0, 00 9, 85 9, 009 TS- Tumor Dormancy Therapy, 7, 007, 0, 00 0 5 0 5