Leemans C R, Tiwari R, van der Waal I, Karim A B, Nauta J J, Snow G B
Department of Otolaryngology-Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.
Laryngoscope. 1990 Nov;100(11):1194-8. doi: 10.1288/00005537-199011000-00012.
Neck recurrence-free curves corrected for local recurrence were compared for 494 patients who underwent 565 comprehensive neck dissections. In 42 dissections, no radicality could be obtained. Of the 523 histologically radical dissections, examination revealed tumor in 352 cases. Patients in whom three or more positive nodes or extranodal spread in one or more nodes were found received postoperative radiotherapy. In the histologically N0 group, the incidence of neck recurrence after 5 years was 3%; in the N+ group as a whole, it was 10%. Analysis of the influence of extranodal spread and the number of positive nodes showed that the group with one or two positive nodes without extranodal spread (that did not receive postoperative radiotherapy) did not statistically differ from the other groups. This suggests that the results of the group with one or two positive nodes without extranodal spread can be improved by postoperative radiotherapy.
对接受了565例根治性颈部清扫术的494例患者，比较了针对局部复发校正后的无颈部复发曲线。在42例清扫术中，未能实现根治性切除。在523例组织学上根治性清扫术中，检查发现352例有肿瘤。发现三个或更多阳性淋巴结或一个或多个淋巴结有结外扩散的患者接受了术后放疗。在组织学N0组中，5年后颈部复发率为3%；在整个N+组中，复发率为10%。对结外扩散和阳性淋巴结数量的影响分析表明，有一两个阳性淋巴结且无结外扩散（未接受术后放疗）的组与其他组在统计学上无差异。这表明，有一两个阳性淋巴结且无结外扩散的组的结果可通过术后放疗得到改善。
