Kruse Astrid L D, Grätz Klaus W
Department of Craniomaxillofacial and Oral Surgery, University of Zurich, Switzerland.
Head Neck Oncol. 2009 Jul 20;1:28. doi: 10.1186/1758-3284-1-28.
Metastases of squamous cell carcinoma of the tongue and the mouth floor have been well studied. Concerning maxilla squamous cell carcinomas, however, only a few studies have been performed. The question is whether a prophylactic neck dissection should be performed in these tumors.
In the Department of Craniomaxillofacial Surgery at the University Hospital of Zurich, 30 patients who had been treated for squamous cell carcinoma of the maxilla were examined retrospectively. Special attention was paid to direct and late metastasis, survival rate, and treatment.
Of the 59 patients with upper jaw carcinomas over a 9-year period, only about half (30 patients) had a squamous cell carcinoma of the upper jaw. Of those patients, 27% had an upper lesion on the right side, 33% on the left. Of the 11 patients (36.7%) presenting positive lymph nodes, 4 patients had direct positive lymph nodes while 7 patients had later positive lymph nodes; and 71.4% of the late metastasis appeared during the first year.
Because of the 36.7% of patients presenting metastases in the cervical lymph nodes, elective neck treatment should be considered in cases even with a negative clinical examination.
舌和口底鳞状细胞癌的转移情况已得到充分研究。然而,关于上颌鳞状细胞癌,仅有少数研究。问题在于这些肿瘤是否应进行预防性颈清扫术。
在苏黎世大学医院颅颌面外科,对30例接受上颌鳞状细胞癌治疗的患者进行了回顾性研究。特别关注了直接转移和晚期转移、生存率及治疗情况。
在9年期间的59例上颌癌患者中,仅有约一半(30例)为上颌鳞状细胞癌。在这些患者中,右侧上颌病变占27%,左侧占33%。在11例(36.7%)出现阳性淋巴结的患者中,4例为直接阳性淋巴结,7例为晚期阳性淋巴结;71.4%的晚期转移出现在第一年。
由于36.7%的患者出现颈部淋巴结转移,即使临床检查为阴性,在某些病例中也应考虑选择性颈部治疗。