Imre Kadir, Pinar Ercan, Oncel Semih, Calli Caglar, Tatar Bekir
Otolaryngology Department, Ataturk Training and Research Hospital, Izmir, Turkey.
Eur Arch Otorhinolaryngol. 2008 Mar;265(3):337-9. doi: 10.1007/s00405-007-0464-0. Epub 2007 Sep 27.
We investigated effect of clinical and pathologic parameters on extracapsular spread (ECS) in patients with lymph node metastasis in laryngeal and hypopharyngeal cancer. About 186 patients and 342 neck dissection were included in this study. Relationship between ECS and tumor location, T stage, pathologic N stage, tumor differentiation, number of metastatic lymph nodes, diameter of metastatic lymph node and impact of presence ECS on contralateral neck metastasis (CNM) were evaluated; 76 of the 186 patients had lymph node metastasis. Of the 76 patients, 31 (40.7%) had ECS. Tumor location, pathologic N stage of the tumor, number of metastatic lymph nodes, diameter of metastatic lymph node and the presence of CNM were significantly associated with ECS (P < 0.05). Only number of (>or=3) lymph node metastasis emerged as significant independent predictor of ECS (P < 0.05; OR:11.6). In conclusion, the number of metastatic lymph nodes (>or=3) should be used as predictor of ECS. Furthermore, contralateral neck dissection should be performed in patients with ipsilateral lymph node metastasis with ECS.
我们研究了临床和病理参数对喉癌和下咽癌伴淋巴结转移患者包膜外扩散（ECS）的影响。本研究纳入了约186例患者和342例颈部清扫术。评估了ECS与肿瘤位置、T分期、病理N分期、肿瘤分化、转移淋巴结数量、转移淋巴结直径以及ECS的存在对侧颈部转移（CNM）的影响；186例患者中有76例发生淋巴结转移。在这76例患者中，31例（40.7%）出现ECS。肿瘤位置、肿瘤的病理N分期、转移淋巴结数量、转移淋巴结直径以及CNM的存在与ECS显著相关（P<0.05）。只有转移淋巴结数量（≥3个）是ECS的显著独立预测因素（P<0.05；OR：11.6）。总之，转移淋巴结数量（≥3个）应用作ECS的预测指标。此外，对同侧淋巴结转移伴ECS的患者应进行对侧颈部清扫术。
