Lee Sei Young, Lim Young Chang, Song Mee Hyun, Lee Jin Seok, Koo Bon Seok, Choi Eun Chang
Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Oral Oncol. 2006 Nov;42(10):1017-21. doi: 10.1016/j.oraloncology.2005.12.023. Epub 2006 Jun 6.
This study investigated the oncologic safety of preserving level IIb lymph nodes in ipsilateral and/or contralateral elective neck dissection (END) in patients with oropharyngeal squamous cell carcinoma (SCC). Fifty-one oropharyngeal SCC patients who underwent surgery as an initial treatment were reviewed. Twenty-one patients had clinically node negative necks (cN0) while 30 patients had ipsilateral clinically node positive necks (cN+). Of the cN0 patients, bilateral or ipsilateral END was performed in 15 and six patients, respectively. For the cN+ cases, ipsilateral therapeutic neck dissection with contralateral END was performed in 24 of 30 patients. In the cN0 patients, nodal metastasis to level IIb lymph nodes was not observed in any ipsilateral (21) or contralateral necks (15). Of the 24 cN+ patients who underwent contralateral END, two cases (8.3%) showed contralateral occult level IIb lymph node metastasis. Our data suggest that in cN0 oropharyngeal cancer patients, level IIb lymph nodes may be preserved in ipsilateral and contralateral neck dissection. However, caution is advised when preserving contralateral level IIb nodes in ipsilateral cN+ cases.
本研究调查了口咽鳞状细胞癌（SCC）患者在同侧和/或对侧选择性颈清扫术（END）中保留IIb级淋巴结的肿瘤学安全性。回顾了51例接受手术作为初始治疗的口咽SCC患者。21例患者颈部临床淋巴结阴性（cN0），30例患者同侧颈部临床淋巴结阳性（cN+）。在cN0患者中，分别有15例和6例进行了双侧或同侧END。对于cN+病例，30例患者中有24例进行了同侧治疗性颈清扫术加对侧END。在cN0患者中，同侧（21例）或对侧颈部（15例）均未观察到IIb级淋巴结转移。在24例接受对侧END的cN+患者中，2例（8.3%）出现对侧隐匿性IIb级淋巴结转移。我们的数据表明，在cN0口咽癌患者中，同侧和对侧颈清扫术中均可保留IIb级淋巴结。然而，在同侧cN+病例中保留对侧IIb级淋巴结时建议谨慎。
