pN1 - N2c期口腔及口咽癌颈淋巴结清扫术中颈内静脉的保留
Internal jugular vein preservation in neck dissection for pN1-N2c oral and oropharyngeal carcinoma.
作者信息
Pontes Everton, Filho João Gonçalves, Agra Ivan Marcelo Gonçalves, Carvalho André Lopes, Magrin José, Kowalski Luiz Paulo
机构信息
Head and Neck Surgery and Otorhinolaryngology Department, Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo, -Fundação Antonio Prudente, São Paulo, Brazil.
出版信息
Am J Otolaryngol. 2007 Sep-Oct;28(5):316-20. doi: 10.1016/j.amjoto.2006.10.002.
PURPOSE
The aim of this study is to evaluate risk factors of neck recurrence in patients with pN1-N2 neck stage, submitted to a modified radical neck dissection with preservation of the internal jugular vein.
MATERIALS AND METHODS
We reviewed the medical records of 72 patients with squamous cell carcinoma of the oral cavity (43 cases) and oropharynx (29 cases). The clinical stage of the neck was N1 in 23 cases and N2a-c in 49.
RESULTS
Neck recurrences occurred in 6 cases at the side in which the internal jugular vein was preserved. Neck recurrence did not have significant correlation with tumor site (P = .391), T stage (P = .999), N stage (P = .203), adjuvant radiotherapy (P = .999), number of positive lymph nodes (P = .180), lymph nodes size (P = .429), and extracapsular spread (P = .400).
CONCLUSIONS
Modified radical neck dissection with internal jugular vein preservation can be performed in selected patients with lymph node metastases, with no significant increase on the risk of neck recurrence.
目的
本研究旨在评估接受保留颈内静脉的改良根治性颈清扫术的pN1 - N2期颈部患者颈部复发的危险因素。
材料与方法
我们回顾了72例口腔鳞状细胞癌（43例）和口咽鳞状细胞癌（29例）患者的病历。颈部临床分期为N1的有23例，N2a - c的有49例。
结果
在保留颈内静脉一侧有6例出现颈部复发。颈部复发与肿瘤部位（P = 0.391）、T分期（P = 0.999）、N分期（P = 0.203）、辅助放疗（P = 0.999）、阳性淋巴结数量（P = 0.180）、淋巴结大小（P = 0.429）及包膜外扩散（P = 0.400）均无显著相关性。
结论
对于部分有淋巴结转移的患者可施行保留颈内静脉的改良根治性颈清扫术，且不会显著增加颈部复发风险。
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