Al-Rajhi Nasser M, Khafaga Yasser M, Saleem Mohammad, Al-Zahrani Ali M, Al-Hebshi Adnan S, El-Husseiny Gamal A, Mourad Walid A, Al-Otieschan Abdullah T, Al-Amro Abdullah S
Division of Radiation Oncology, King Faisal Specialist Hospital & Research Centre, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia.
Saudi Med J. 2002 Nov;23(11):1343-6.
To evaluate elective neck treatment in patients with early stage (T1-2 negative neck node [N0]) squamous cell carcinoma of the oral tongue.
The medical records of all patients with early stage (T1-2 N0) of oral tongue cancer at the King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia, between January 1980 and December 1997, were identified and retrospectively reviewed.
Our cohort consisted of 93 patients: 45 males and 48 females, with a median age of 60 years. All patients received treatment with curative intent. Partial glossectomy was carried out, except for 8 patients who underwent tongue brachytherapy. The neck was observed in 29 patients, 36 were treated by modified neck dissection, and 28 by elective neck irradiation. With a median follow-up of 62 months, 29 patients had documented neck node recurrence. Ninety six percent (28/29) of recurrences occurred within 22 months from treatment completion. The 5 year actuarial event free survival with regard to nodal relapse in observed was 59%, dissected was 79% and irradiated neck was 63%. Our results showed a trend toward better neck node control in patients managed by elective neck dissection compared to those observed (p=0.07) or receiving elective neck irradiation (p=0.18). Tumor thickness of more than 10 mm was associated with increased risk of nodal relapse (p=0.0004). Neck node recurrence has a poor prognosis with a 5 year disease specific survival of 16%.
A trend for higher neck control was observed after neck dissection in patients with T1-2 N0 squamous cell carcinoma of the oral tongue. Elective neck dissection should be considered particularly for patients with tumor thickness of more than 10 mm.
评估早期（T1-2期，颈部阴性淋巴结[N0]）口腔舌鳞状细胞癌患者的选择性颈部治疗。
确定并回顾性分析了1980年1月至1997年12月期间在沙特阿拉伯王国利雅得法赫德国王专科医院及研究中心诊断为早期（T1-2 N0）口腔舌癌的所有患者的病历。
我们的队列包括93例患者，其中男性45例，女性48例，中位年龄为60岁。所有患者均接受了根治性治疗。除8例接受舌近距离放疗的患者外，其余均行部分舌切除术。29例患者对颈部进行观察，36例行改良颈清扫术，28例行选择性颈部放疗。中位随访62个月，29例患者有颈部淋巴结复发记录。96%（28/29）的复发发生在治疗完成后的22个月内。观察组、颈清扫组和颈部放疗组淋巴结复发的5年无事件精算生存率分别为59%、79%和63%。我们的结果显示，与观察组（p=0.07）或接受选择性颈部放疗组（p=0.18）相比，选择性颈清扫术治疗的患者颈部淋巴结控制趋势更好。肿瘤厚度超过10 mm与淋巴结复发风险增加相关（p=0.0004）。颈部淋巴结复发预后较差，5年疾病特异性生存率为16%。
对于T1-2 N0口腔舌鳞状细胞癌患者，颈清扫术后观察到颈部控制率较高的趋势。对于肿瘤厚度超过10 mm的患者，尤其应考虑选择性颈清扫术。
