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挽救性手术治疗鼻咽癌颈部残留或复发:10 年经验。

Salvage surgery for neck residue or recurrence of nasopharyngeal carcinoma: a 10-year experience.

机构信息

Department of Head and Neck Surgery, Fudan University Cancer Hospital, Shanghai, People's Republic of China.

出版信息

Ann Surg Oncol. 2011 Jan;18(1):233-8. doi: 10.1245/s10434-010-1292-9. Epub 2010 Aug 25.

Abstract

BACKGROUND

To assess the outcome of and determine prognostic factors for neck residue or recurrence of nasopharyngeal carcinoma (NPC) in patients treated with a salvage neck dissection.

MATERIALS AND METHODS

Over a 10-year period (from January 1998 through December 2007) in a tertiary hospital, we systematically reviewed the clinical charts of 355 patients with NPC who were diagnosed with neck residue or recurrence of nasopharyngeal carcinoma, after radical definitive radiotherapy with or without chemotherapy.

RESULTS

The group with recurrent nodal disease consisted of 285 patients (80.3%), while the group with residual nodal disease included 70 patients (19.7%). There were no patients died of the surgery complications. Overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were 54.11, 35.01, and 55.59%, respectively, at 3-year, and 26.03, 22.65, and 27.84%, respectively, at 5-year. The local control rate in the neck was 70.92% at 3 years and 60.98% at 5 years. For all the 3 survival outcomes (OS, DFS, and DSS) and the local control rate of disease in the neck, there were significant differences between the "residue group" and "recurrence group."

CONCLUSIONS

Radical neck dissection is proven to be safe and effective in the treatment of the neck failure. Our study has demonstrated that it may be possible to choose the selective lymph node dissection for patients of the residue group.

摘要

背景

评估挽救性颈清扫术后残留或复发鼻咽癌(NPC)患者的结局,并确定其预后因素。

材料与方法

在一家三级医院,我们回顾性分析了 1998 年 1 月至 2007 年 12 月间接受根治性放化疗后出现 NPC 颈部残留或复发的 355 例患者的临床资料。

结果

复发淋巴结组 285 例(80.3%),残留淋巴结组 70 例(19.7%)。无手术相关死亡病例。3 年总体生存率(OS)、无病生存率(DFS)和疾病特异性生存率(DSS)分别为 54.11%、35.01%和 55.59%,5 年 OS、DFS 和 DSS 分别为 26.03%、22.65%和 27.84%。3 年时颈部局部控制率为 70.92%,5 年时为 60.98%。所有 3 项生存结局(OS、DFS 和 DSS)和颈部疾病局部控制率在“残留组”和“复发组”之间差异均有统计学意义。

结论

根治性颈清扫术治疗颈部失败安全有效,本研究表明对于残留组患者可以选择选择性淋巴结清扫术。

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