Pan Z, Cao Z, Liu B
Department of Otolaryngology, First Affiliated Hospital of China Medical University, Shenyang 110001.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 1999 Apr;34(2):108-10.
To evaluate the regional control efficacy of elective neck dissection (END) in patients with supraglottic carcinoma.
The incidence of cervical recurrences of 582 patients with supraglottic carcinoma treated in this hospital from 1981 to 1993 were retrospectively reviewed.
Three hundred and ninety-two cases (67.35%) of this group had T3 and T4 primary lesions. Among them, 147 cases (37.50%) had positive nodes(N+) and this accounted for 86.47% (147/170) of all N+ patients. Ipsilateral or bilateral cervical recurrence occurred in 33 of 126 (26.19%) node negative (N0) cases who had not had neck dissection and 30 of them (90.90%) were among T3 and T4 groups. However, Contralateral lymph node recurrence occurred only in 40 of 286(13.99%) N0 cases who had had END and 30 of them (75%) were among T3 and T4 groups. There were 163 cases who were readmitted and received surgery again for different purposes. The three and five year survival rates in the second stage END group were 86.67% and 77.78%, in metastasis group 64.81% and 32.50%, in recurrent group 33.33% and 30.77% respectively. There were significant differences in survival rates among these groups.
Patients underwent elective neck dissection achieved better survival than those on "wait and watch" policy and salvage surgery. Elective neck dissection is recommended for the treatment of supraglottic carcinoma, especially for the T3 and T4 diseases.
评估选择性颈部清扫术（END）对上声门癌患者的区域控制疗效。
回顾性分析1981年至1993年在本院接受治疗的582例上声门癌患者颈部复发的发生率。
该组392例（67.35%）患者有T3和T4期原发灶。其中，147例（37.50%）有阳性淋巴结（N+），占所有N+患者的86.47%（147/170）。126例未行颈部清扫术的淋巴结阴性（N0）患者中有33例（26.19%）发生同侧或双侧颈部复发，其中30例（90.90%）在T3和T4组。然而，在接受END的286例N0患者中，仅40例（13.99%）发生对侧淋巴结复发，其中30例（75%）在T3和T4组。有163例患者因不同目的再次入院并接受手术。二期END组的三年和五年生存率分别为86.67%和77.78%，转移组为64.81%和32.50%，复发组为33.33%和30.77%。这些组之间的生存率有显著差异。
接受选择性颈部清扫术的患者比采取“观察等待”策略和补救性手术的患者有更好的生存率。推荐对上声门癌患者，尤其是T3和T4期疾病患者行选择性颈部清扫术。
