口腔鳞状细胞癌中前哨淋巴结阳性的意义。
Implications of a positive sentinel node in oral squamous cell carcinoma.
机构信息
Department of Oral and Maxillofacial Surgery, Department of Oncology, Guy's King's and St Thomas's Hospital, London, United Kingdom.
出版信息
Head Neck. 2012 Nov;34(11):1580-5. doi: 10.1002/hed.21973. Epub 2012 Jan 31.
BACKGROUND
The role of sentinel node biopsy in head and neck cancer is currently being explored. Patients with positive sentinel nodes were investigated to establish if additional metastases were present in the neck, their distribution, and their impact on outcome.
METHODS
In all, 109 patients (n = 109) from 15 European centers, with cT1/2,N0 tumors, and a positive sentinel lymph node were identified. Kaplan-Meier and univariate and multivariate logistic regression analysis were used to identify variables that predicted for additional positive nodes and their position within the neck.
RESULTS
A total of 122 neck dissections were performed in 109 patients. Additional positive nodes were found in 34.4% of cases (42/122: 18 same, 21 adjacent, and 3 nonadjacent neck level). Additional nodes, especially if outside the sentinel node basin, had an impact on outcome.
CONCLUSIONS
The results are preliminary but suggest that both the number and the position of positive sentinel nodes may identify different prognostic groups that may allow further tailoring of management plans.
背景
前哨淋巴结活检在头颈部癌症中的作用目前正在探索中。对阳性前哨淋巴结的患者进行了调查，以确定颈部是否存在其他转移灶、其分布情况以及对预后的影响。
方法
在 15 个欧洲中心共纳入了 109 例 cT1/2、N0 肿瘤且前哨淋巴结阳性的患者。采用 Kaplan-Meier 法和单因素及多因素 logistic 回归分析，确定预测额外阳性淋巴结及其在颈部位置的变量。
结果
在 109 例患者中，共进行了 122 例颈部清扫术。在 42/122 例（18 例相同、21 例相邻和 3 例非相邻颈部水平）病例中发现了额外的阳性淋巴结。额外的淋巴结，特别是位于前哨淋巴结区域外的淋巴结，对预后有影响。
结论
结果尚属初步，但提示阳性前哨淋巴结的数量和位置可能可以识别不同的预后组，从而可能进一步制定更个体化的治疗方案。
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