Wiegand Susanne, Esters Judith, Müller Hans-Helge, Jäcker Tim, Roessler Marion, Werner Jochen A, Sesterhenn Andreas M
Department of Otolaryngology, Head and Neck Surgery, UKGM, Marburg, Germany.
Acta Otolaryngol. 2010 Jun;130(6):747-52. doi: 10.3109/00016480903384168.
The low incidence of metastases in levels I and IIB in patients with hypopharyngeal cancer in cases of clinical N0 and N+ neck and the fact that all patients with metastases in levels I and IIB received postoperative radiotherapy justifies the preservation of levels I and IIB in patients with hypopharyngeal cancer to improve functional results and reduce the operating time.
Neck dissection of levels I and IIB is technically demanding due to the complex local anatomy and can cause several comorbidities. Therefore the aim of the study was to analyze whether levels I and IIB have to be dissected in patients with hypopharyngeal cancer.
This was a retrospective analysis of all patients who underwent primary surgical treatment for hypopharyngeal cancer and neck dissection, with evaluation of the incidence of metastases in levels I and IIB in cases of cN0 and cN+ neck.
None of the patients with cN0 neck but 2/33 patients with cN+ neck had metastases in level I. Metastases in level IIB were detected in 1/14 patients with cN0 neck and 2/36 patients with cN+ neck. All patients with metastases in levels I and IIB received postoperative radiotherapy due to the N2b and N2c status.
下咽癌患者临床N0和N+颈部病例中I区和IIB区转移发生率较低，且所有I区和IIB区有转移的患者均接受了术后放疗，这证明在下咽癌患者中保留I区和IIB区以改善功能结果并缩短手术时间是合理的。
由于局部解剖结构复杂，I区和IIB区的颈部清扫术技术要求高，且可能导致多种合并症。因此，本研究的目的是分析下咽癌患者是否必须清扫I区和IIB区。
这是一项对所有接受下咽癌一期手术治疗和颈部清扫术的患者进行的回顾性分析，评估cN0和cN+颈部病例中I区和IIB区转移的发生率。
cN0颈部的患者中无一例I区有转移，但cN+颈部的33例患者中有2例I区有转移。cN0颈部的14例患者中有1例IIB区有转移，cN+颈部的36例患者中有2例IIB区有转移。所有I区和IIB区有转移的患者因N2b和N2c状态均接受了术后放疗。
