Department of Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Oral Oncol. 2012 Apr;48(4):298-302. doi: 10.1016/j.oraloncology.2011.11.001. Epub 2011 Nov 22.
This systematic review addresses the prognostic significance of neck node volume in head and neck cancer. Primary tumor volume evolved as an independent significant factor for survival in head and neck cancer patients. Besides primary tumor volume, multiple prognostic features related to the regional lymph nodes were studied in literature. In literature, some authors showed the significance of total tumor volume/nodal volume for survival and loco-regional control. Articles reporting prognosis and survival in nodal tumor volumes were collected by systematically reviewing publications listed in the Pubmed and Embase databases. Publications were included when they at least reported on total tumor volume (TTV) or nodal volume and survival. In this systematic review we studied 21 articles. For measurement of nodal volume different formulas were used. Until now, there's no clear statistical evidence for the use of either TTV or nodal volume versus primary tumor volume to predict the individual loco-regional control or survival after treatment. There is wide variety of tumor measuring systems in the literature. The cut-off value for local tumor response also shows large variation. Firstly consensus should be accomplished on standardization of volume measurements, preferably automatic, and secondly large study groups are needed with identical treatment modalities to further unravel the role of neck node volume as separate staging tool.
本系统评价旨在探讨头颈部癌颈部淋巴结体积的预后意义。肿瘤体积已成为头颈部癌患者生存的独立重要因素。除了原发肿瘤体积，文献中还研究了与区域淋巴结相关的多个预后特征。一些作者在文献中表明了总肿瘤体积/淋巴结体积对生存和局部区域控制的意义。通过系统地查阅 Pubmed 和 Embase 数据库中列出的出版物，收集了报告淋巴结肿瘤预后和生存的文章。当文章至少报告了总肿瘤体积（TTV）或淋巴结体积和生存时，就将其纳入研究。在本系统评价中，我们研究了 21 篇文章。对于淋巴结体积的测量，使用了不同的公式。到目前为止，尚无明确的统计证据表明使用 TTV 或淋巴结体积代替原发肿瘤体积来预测治疗后个体的局部区域控制或生存。文献中存在多种肿瘤测量系统，局部肿瘤反应的截止值也存在较大差异。首先应就体积测量的标准化达成共识，最好采用自动方法，其次需要有大量采用相同治疗方式的研究组，以进一步阐明颈部淋巴结体积作为独立分期工具的作用。
