选择性颈清扫术治疗临床阳性颈部的有效性。

Effectiveness of selective neck dissection in the treatment of the clinically positive neck.

作者信息

Patel Rajan S, Clark Jonathan R, Gao Kan, O'Brien Christopher J

机构信息

Sydney Head and Neck Cancer Institute, Sydney Cancer Centre, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia.

出版信息

Head Neck. 2008 Sep;30(9):1231-6. doi: 10.1002/hed.20870.

DOI:10.1002/hed.20870

PMID:18642289

Abstract

BACKGROUND

The aim of this work was to determine whether or not patients treated with therapeutic selective neck dissection for head and neck squamous cell carcinoma were oncologically disadvantaged compared with those having comprehensive procedures.

METHODS

The study involves a retrospective review of 232 therapeutic neck dissections with a minimum of 2 years follow-up.

RESULTS

Patients having selective neck dissection had fewer adverse prognostic factors compared with patients having comprehensive dissection (pN2/3, p = .001; and extracapsular spread, p = .001). There were trends toward improved control in the dissected neck (96% vs 86%, p = .06), and disease-specific survival (59% vs 43%, p = .06) following selective neck dissection. Disease-specific survival for all patients was adversely affected by pN classification (p <.001) and extracapsular spread (p <.001).

CONCLUSIONS

Patients undergoing aggressive neck surgery had more extensive disease. Selective neck dissection can be used to effectively treat clinically positive nodal disease in selected patients.

摘要

背景

本研究旨在确定接受治疗性选择性颈部清扫术治疗的头颈部鳞状细胞癌患者与接受综合性手术的患者相比在肿瘤学方面是否处于劣势。

方法

本研究对232例接受治疗性颈部清扫术且随访至少2年的患者进行了回顾性分析。

结果

与接受综合性清扫术的患者相比，接受选择性颈部清扫术的患者不良预后因素较少（pN2/3，p = 0.001；以及包膜外扩散，p = 0.001）。选择性颈部清扫术后，清扫侧颈部的控制情况（96%对86%，p = 0.06）和疾病特异性生存率（59%对43%，p = 0.06）有改善趋势。所有患者的疾病特异性生存率受到pN分级（p <0.001）和包膜外扩散（p <0.001）的不利影响。