Shingaki S, Nomura T, Takada M, Kobayashi T, Suzuki I, Nakajima T
First Department of Oral and Maxillofacial Surgery, School of Dentistry, Niigata University, Niigata City, Japan.
Int J Oral Maxillofac Surg. 1999 Aug;28(4):279-84.
A retrospective study of 61 patients with histologically confirmed lymph node metastases was undertaken to evaluate the prognostic significance of extranodal spread (ENS) of metastases on the patterns of treatment failure and survival. ENS was present in 28 (46%) of the 61 patients and it was significantly associated with N stage. T stage, clinical stage, number of positive nodes, level of metastases, mode of treatment, and histological differentiation, however, did not influence the incidence of ENS. The 5-year disease-specific survival rate was 57%. The values for patients with and without ENS were 40% and 72%, respectively, which were statistically significant. The univariate analysis showed that the presence of ENS was a significant predictor of patient survival (P = 0.008). The number and level of positive nodes and postoperative radiotherapy had no prognostic importance. ENS, however, was also associated with an increased risk of distant metastases.
对61例经组织学确诊有淋巴结转移的患者进行了一项回顾性研究，以评估转移灶的结外扩散（ENS）对治疗失败模式和生存的预后意义。61例患者中有28例（46%）存在ENS，且其与N分期显著相关。然而，T分期、临床分期、阳性淋巴结数量、转移水平、治疗方式和组织学分化并未影响ENS的发生率。5年疾病特异性生存率为57%。有和无ENS的患者生存率分别为40%和72%，差异有统计学意义。单因素分析显示，ENS的存在是患者生存的重要预测因素（P = 0.008）。阳性淋巴结的数量和水平以及术后放疗无预后意义。然而，ENS也与远处转移风险增加相关。
