口腔鳞状细胞癌患者临床 N0 颈部采用 I 至 IV 区或 I 至 III 区选择性颈清扫术后的颈部复发。
Neck recurrence after level I-IV or I-III selective neck dissection in the management of the clinically N0 neck in patients with oral squamous cell carcinoma.
机构信息
School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
出版信息
Head Neck. 2011 Mar;33(3):403-6. doi: 10.1002/hed.21466.
BACKGROUND
Controversy remains regarding extending the level I-III selective neck dissection (SND) to include level IV in the management of the clinically N0 (cN0) neck in patients with oral squamous cell carcinoma (OSCC).
METHODS
Histologic and follow-up data of 87 patients with previously untreated OSCC undergoing I-IV SND and 41 undergoing I-III SND between 2002 and 2006 were reviewed.
RESULTS
Of the 98 I-IV SNDs performed, 4 had involvement of level IV. No relationship between tumor variables and level IV involvement was identified. Survival analysis failed to demonstrate a significant difference between I-III and I-IV SND in terms of developing neck recurrence in the 2 years following surgery.
CONCLUSIONS
Level I-III SND is effective management of the cN0 neck (when coupled with postoperative radiotherapy in selected cases) in patients with OSCC, although it is recommended that a larger prospective study be performed in this field.
背景
对于临床 N0（cN0）颈的口腔鳞状细胞癌（OSCC）患者，将 I-III 级选择性颈清扫术（SND）扩展至包括 IV 级，这一做法仍存在争议。
方法
回顾了 2002 年至 2006 年间 87 例接受 I-IV SND 和 41 例接受 I-III SND 的未经治疗的 OSCC 患者的组织学和随访数据。
结果
在进行的 98 例 I-IV SND 中，有 4 例涉及 IV 级。肿瘤变量与 IV 级受累之间没有关系。生存分析表明，在手术后 2 年内发生颈部复发方面，I-III 和 I-IV SND 之间无显著差异。
结论
对于 OSCC 患者的 cN0 颈部（在某些情况下结合术后放疗），I-III SND 是有效的管理方法，尽管建议在该领域进行更大规模的前瞻性研究。
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