Prognostički faktori u oralnom karcinomu

master's thesis

• Author: Karlo Šojat
• Mentor: Livije Kalogjera (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2006, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Prognoza intraoralnog karcinoma ovisi o stadiju bolesti, tj. o opsegu primarnog tumora i statusa vrata. Najvažniji prognostički faktor je stanje limfnih čvorova vrata. Na lošiju prognozu ukazuje veliki broj zahvaćenih limfnih čvorova, zahvaćenost više skupina limfnih čvorova, metastaze u kojih se histološki dokaže proboj kapsule limfnog čvora, te metastaze nisko na vratu. Bolesnici s prisutnim regionalnim metastazama na vratu imaju dvostruko manje šanse za izlječenje od bolesnika bez metastaza. Fiksirani čvorovi pokazatelji su izuzetno loše prognoze, često recidiva u operiranom vratu, a niske metastaze (regija IV i V) ukazuju na mogućnost hematogene diseminacije s obzirom da u tom području velike limfne žile, bez zaustavljanja u limfnim čvorovima, tumorske stanice unose u cirkulaciju. Općenito se drži kako slabo diferencirani tumori imaju lošiju prognozu od dobro diferenciranih, no prema novijim shvaćanjima veće značenje u prognozi ima debljina tumora. Deblji tumori češće recidiviraju i metastaziraju. Preživljenje bolesnika s početnim tumorima više je od 70%. Međutim, pacijenti se u večini slučajeva liječniku javljaju u kasnijem stadiju bolesti. Pri prvom pregledu metastaze se mogu naći kod oko 40% bolesnika. Među bolesnicima s karcinomom usne šupljine, koji su na početku liječenja bez regionalnih metastaza, oko 60% može očekivati izlječenje. Ako na početku liječenja postoje unilateralne metastaze, izlječenje je moguće kod svega 30%, a pri bilateralno povećanim čvorovima svega 1% bolesnika ima šansu za izlječenje. Učestalost drugog primarnog tumora nakon intraoralnog planocelularnog karcinoma jest od 10 do 27% . U pogledu praćenja bolesnika radi otkrivanja metastaza i recidiva za većinu bolesnika dovoljan je dvogodišnji period. U tom se razdoblju javljaju gotovo svi recidivi i metastaze.

Abstract (english)

The prognosis of the oral carcinoma depends upon the stage that the disease, namely the volume of the primary tumor and the status of the neck. The status of the lymph nodes of the neck is the most important prognostic factor. A large number of
affected lymph nodes and clusters of lymph nodes, metastasis in which the penetration of the lymph node capsule has been histologically proven, and metastasis in the lower regions of the neck indicate a negative prognosis. The prognosis of patients with regional metastasis are twice as low as in those of patients free of metastasis. Fixed nodes indicate an extremely bad prognosis, often a relapse in the neck that was operated upon, and metastasis in the lower regions (region IV and V) indicate the possibility of haematogenic dissemination, considering the fact that in this area large lymphatic vessels carry the tumor cells into the circulation without stopping at the lymph nodes. It is generally accepted that poorly differentiated tumors indicate a worse prognosis than those which are well differentiated, however according to new
opinions the width of the tumor is more important for the prognosis. The survival rate of patients with tumors at an early stage is over 70%. In most cases, however, patients contact a doctor when the disease has already reached a later stage. Upon the first examination metastasis can be found in about 40% of the patients. Among patients with the oral cavity carcinoma, without neck involvement, about 60% may expect to be cured. If unilateral metastasis is present at the beggining of the treatment, cure is possible in only 30% of the patients, and survival is only 1% in the patients with bilateral metastasis.

• Keywords: oralne novotvorine; metastaze tumora
• Keywords (english): Mouth Neoplasms; Neoplasm Metastasis
• Language: croatian
• URN:NBN: urn:nbn:hr:127:016053
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor dentalne medicine (doktor dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Closed access
• Created on: 2024-06-21 09:50:18