Yu Wen-Bin, Zeng Zong-Yuan, Chen Fu-Jin, Zhang Quan, Guo Zhu-Ming, Li Hao, Liu Xue-Kui, Wu Guo-Hao
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Ai Zheng. 2006 Oct;25(10):1271-4.
BACKGROUND & OBJECTIVE: The cervical lymphatic metastasis rate of glottic cancer is low, and has seldom been reported. This study was to explore the factors related to cervical lymphatic metastasis of T3-T4 glottic cancer, and analyze its correlation to prognosis.
Clinical data of 83 patients with T3-T4 glottic cancer, treated in Cancer Center of Sun Yat-sen University from 1992 to 2000, were reviewed retrospectively. The lymphatic metastasis rate, distribution of metastatic lymph nodes, influence factors of neck recurrence of cN0 glottic cancer, and correlation of cervical lymphatic metastasis to prognosis of T3-T4 glottic cancer were analyzed.
Overall lymphatic metastasis rate was 20.5%. The neck recurrence rate of cN0 patients was 14.3%. Most metastatic lymph nodes located at the ipsilateral levels II, III, and IV, while only 1 located at the contralateral level II. For cN0 patients, there was no difference in the neck recurrence rate between observation group and prophylactic cervical radiation group (P=0.772). Histopathologic differentiation affected the neck recurrence of cN0 patients (P=0.028); while T stage did not relate to the neck recurrence (P=0.217). The prognosis of cN+ patients was poorer than that of cN0 patients (P<0.001). The neck recurrence of CN0 patients did not affect the prognosis (P=0.460).
Most metastatic lymph nodes of T3-T4 glottic cancer locate at the ipsilateral levels II, III, and IV. Poor differentiation is significantly correlated to high risk of neck recurrence among cN0 patients. However, the recurrence does not affect the prognosis. Close observation should be done to the cervix of cN0 patients; while neck dissection should be done to cN+ patients.
声门癌的颈部淋巴结转移率较低，相关报道较少。本研究旨在探讨T3 - T4期声门癌颈部淋巴结转移的相关因素，并分析其与预后的相关性。
回顾性分析1992年至2000年在中山大学肿瘤防治中心接受治疗的83例T3 - T4期声门癌患者的临床资料。分析其淋巴结转移率、转移淋巴结分布、cN0声门癌颈部复发的影响因素以及颈部淋巴结转移与T3 - T4期声门癌预后的相关性。
总体淋巴结转移率为20.5%。cN0患者的颈部复发率为14.3%。大多数转移淋巴结位于同侧Ⅱ、Ⅲ、Ⅳ区，而对侧Ⅱ区仅有1枚。对于cN0患者，观察组与预防性颈部放疗组的颈部复发率无差异（P = 0.772）。组织病理学分化影响cN0患者的颈部复发（P = 0.028）；而T分期与颈部复发无关（P = 0.217）。cN +患者的预后比cN0患者差（P < 0.001）。cN0患者的颈部复发不影响预后（P = 0.460）。
T3 - T4期声门癌的大多数转移淋巴结位于同侧Ⅱ、Ⅲ、Ⅳ区。分化差与cN0患者颈部复发的高风险显著相关。然而，复发并不影响预后。对cN0患者的颈部应密切观察；而对cN +患者应行颈部清扫术。
