本研究对考虑侵犯腭舌肌 (PGM) 作为口咽鳞状细胞癌 (OPSCC) T4 分期标准的适当性提出质疑。回顾性观察研究。第三大学医院。这项回顾性研究包括接受治疗的非转移性 OPSCC 患者2015年至2021年在意大利的里雅斯特大学进行的研究。患者被分为4组：（1）国际癌症控制（UICC）和美国癌症联合委员会（AJCC）-TNM均分类为T1-T2的肿瘤； (2) T1-T2肿瘤因口咽部PGM浸润仅通过UICC升级为T4； (3) T1-T2肿瘤由于口腔PGM浸润，经UICC和AJCC均升级为T4； (4)UICC和AJCC均分类为T3-T4的肿瘤。 Kaplan-Meier 分析估计了总生存期 (OS) 和无病生存期 (DFS)。根据临床因素进行调整的多变量 Cox 模型评估了腭舌肌侵犯对 5 年以上结局的影响。总共纳入了 121 名连续的原发性 OPSCC 患者（中位[四分位距]年龄 65 岁[58-74]；63% 为男性）。虽然由于 PGM 口腔部分浸润而导致 T4 类别升级的患者表现出与其他晚期疾病患者相同的预后，但由于 PGM 口咽部分浸润而导致 T4 类别升级的患者表现出 OS 和 DFS 相当T1-T2 患者。我们的研究结果强调，PGM 口咽部分的侵犯可能不是 OPSCC 分期为 T4 的合适标准。强烈鼓励开展涉及更大且独立患者群体的进一步研究，以证实这些观察结果。© 2024 作者。耳鼻喉科 - 头颈外科由 Wiley periodicals LLC 代表美国耳鼻喉科 - 头颈外科基金会基金会出版。

The present study challenges the appropriateness of considering invasion of the palatoglossus muscle (PGM) as a criterion for staging oropharyngeal squamous cell carcinoma (OPSCC) as T4.Retrospective observational study.Tertiary University Hospital.This retrospective study included nonmetastatic OPSCC patients treated with curative intent at the University of Trieste, Italy from 2015 to 2021. Patients were categorized into 4 groups: (1) tumors classified as T1-T2 by both International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC)-TNM; (2) T1-T2 tumors upgraded to T4 solely by UICC due to oropharyngeal PGM infiltration; (3) T1-T2 tumors upgraded to T4 by both UICC and AJCC due to oral PGM infiltration; (4) tumors classified as T3-T4 by both UICC and AJCC. Kaplan-Meier analysis estimated overall survival (OS) and disease-free survival (DFS). Multivariable Cox models, adjusted for clinical factors, assessed the impact of palatoglossus invasion on outcomes over 5 years.A total of 121 consecutive patients with primary OPSCC were included (median [interquartile range] age 65 years [58-74]; 63% male). While patients with upgraded T4 category due to infiltration of the oral portion of the PGM exhibited a prognosis superimposable on that of other patients with advanced stage disease, those with upgraded T4 category due to infiltration of the oropharyngeal portion of the PGM displayed OS and DFS comparable to T1-T2 patients.Our findings highlight that invasion of the oropharyngeal portion of the PGM may not be a suitable criterion for staging OPSCC as T4. Further research involving larger and independent patient cohorts is strongly encouraged to corroborate these observations.© 2024 The Author(s). Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.