Califano L, Zupi A, Mangone G M, Longo F, Coscia G, Piombino P
School of Medicine and Surgery, Department of Maxillofacial Surgery, Federico II University of Naples, Italy.
Br J Oral Maxillofac Surg. 1999 Aug;37(4):320-3. doi: 10.1054/bjom.1999.0076.
If the nodes are involved, survival of patients with squamous cell carcinoma of the tongue is considerably reduced. Surgery remains the treatment of choice and, to define its role, we have reviewed 82 consecutive cases. Sixty-two cases (76%) were T1-2, and 46 patients (56%) had involved nodes. The cervical region II was the most often involved (n=26). Occult nodal metastases were present in 12 cases. The extent of nodal spread and prognosis varies according to whether the body or the base of the tongue is involved. Lesions of the base with involved node should be treated by a selective posterolateral neck dissection, whilst in the case of a lesion of the body of the tongue, the dissection should be selective anterolateral. In lesions of the base, when there are no nodes involved, a prophylactic selective posterolateral neck dissection is recommended, whilst in the case of the lesions of the body, selective supraomohyoid neck dissection in T2-4 lesions is recommended.
如果出现淋巴结受累情况，舌鳞状细胞癌患者的生存率会显著降低。手术仍然是首选治疗方法，为明确其作用，我们回顾了连续的82例病例。62例（76%）为T1-2期，46例（56%）有淋巴结受累。颈部Ⅱ区是最常受累的部位（n = 26）。12例存在隐匿性淋巴结转移。淋巴结扩散的范围和预后因舌体或舌根受累情况而异。舌根病变伴有淋巴结受累时，应行选择性后外侧颈清扫术，而对于舌体病变，清扫术应选择前外侧。对于舌根病变，若没有淋巴结受累，建议行预防性选择性后外侧颈清扫术，而对于舌体病变，T2-4期病变建议行选择性肩胛舌骨上颈清扫术。
