Oberkiefermalignome – Ergebnisse einer monozentrischen Studie über 45 Jahre

Zusammenfassung

Hintergrund Malignome der Oberkieferregion sind vergleichsweise selten. Ziel der monozentrischen retrospektiven Studie war, Aussagen zur Histologie, zum Grading und zum Staging dieser Tumoren treffen zu können.

Material und Methoden Seit 1969 wurden insgesamt 199 Patienten retrospektiv untersucht, bei denen aufgrund einer malignen Neubildung des Oberkiefers eine chirurgische bzw. kombiniert chirurgisch-radiotherapeutische Behandlung erfolgte. Kernstück der Analyse waren neben der histologischen Einteilung aller Malignome beim Plattenepithelkarzinom die TNM-Klassifikation, die histomorphologische Differenzierung (Grading) wie auch die Überlebenswahrscheinlichkeit nach Kaplan-Meier.

Ergebnisse Es zeigt sich, dass Plattenepithelkarzinome mit etwa 60% die häufigsten Malignome des Oberkiefers waren. Ihre 5-Jahres-Überlebenswahrscheinllichkeit lag mit mehr als 60% deutlich über den Werten anderer Mundhöhlenkarzinome, obgleich etwa ⅔ der Tumoren im fortgeschrittenen T4-Stadium waren. Die Plattenepithelkarzinome waren zu etwa ⅔ der Fälle gut differenziert, G2- und G3-Tumoren fanden sich deutlich seltener.

Schlussfolgerung Die Rezidivhäufigkeit erhöht sich mit steigender Entdifferenzierung im Gegensatz zur Überlebenswahrscheinlichkeit. Insgesamt lassen Oberkieferkarzinome bei adäquater chirurgischer und radiologischer Therapie gute ästhetische und befriedigende funktionelle Resultate erwarten.

Abstract

Background Malignancies originating from the upper jaw are comparatively rare. This study aimed to evaluate the histological features, grading and staging in upper jaw carcinomas.

Materials and Methods A total of 199 malignancies of the maxillary sinus were analysed over 45 years and matched for age, gender, tumour size, and histological differentiation. Cases of squamous cell carcinomas were classified based on the TNM system, grading and five-year survival time.

Results Squamous cell carcinomas (60%) were the most frequent malignant tumours. The five-year survival rate of squamous cell carcinomas was more than 60% and hence superior to that of other oral squamous cell carcinomas, although approximately ⅔ of these tumours were T4 cases. More than 60% of squamous cell carcinomas were highly differentiated and characterised as G1 tumours. G2 and G3 tumours were considerably less common.

Conclusion The risk of local recurrence was inversely disproportional to the grade of histological differentiation. All in all, an optimal surgical and radiological treatment may lead to good aesthetic and satisfactory functional results.

Schlüsselwörter

Prognose - Malignome des Oberkiefers, Behandlungsergebnisse, Überlebenszeit - Überleben - Langzeitüberleben

Key words

prognosis - malignant neoplasms of maxillary sinus, treatment outcomes, survival time - survival - upper jaw carcinoma

^* Beide Autoren haben zu gleichen Teilen zum Manuskript beigetragen.

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