Division of Maxillofacial Diagnostic and Surgical Sciences, Department of Oral and Maxillofacial Surgery, Graduate School of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
J Oncol. 2012;2012:634183. doi: 10.1155/2012/634183. Epub 2012 May 28.
Objective. To evaluate the efficacy of selective submandibular neck dissection (SMND) in patients with oral squamous cell carcinoma (OSCC) with or without nodal metastasis. Patients. From a total of 384 patients with untreated OSCC who underwent radical excision, we identified 229 with clinically N0 necks and 68 with clinically N1 necks in level I. Main Outcome Measures. The Kaplan-Meier 5-year regional control and 5-year disease specific survival (DSS) were compared for SMND, radical neck dissection (RND), and modified radical neck dissection (MRND). Results. In clinically node-negative necks, the regional control rates were 85.2% with SMND and 83.3% with MRND (P = 0.89), and 5-year DSS rates were 86.5% and 87.0%, respectively, (P = 0.94). In clinically N1 necks, the regional control rates were 81.3% with SMND and 83.0% with RND (P = 0.72), and the DSS rates were 81.3% and 80.0%, respectively, (P = 0.94). Type of neck dissection was not significantly associated with regional control or DSS on either univariate or multivariate analysis using Cox's proportional hazard model. Conclusions. SMND can be effectively applied in elective and therapeutic management to patients with OSCC that are clinically assessed as N0 or N1 to level I of the neck.
目的。评估选择性颌下颈部解剖术（SMND）在伴或不伴淋巴结转移的口腔鳞状细胞癌（OSCC）患者中的疗效。
患者。从 384 例接受根治性切除术的未经治疗的 OSCC 患者中，我们共确定了 229 例临床 N0 颈部和 68 例临床 N1 颈 I 水平的患者。
主要观察指标。比较 SMND、根治性颈部解剖术（RND）和改良根治性颈部解剖术（MRND）的 Kaplan-Meier 5 年区域控制率和 5 年疾病特异性生存率（DSS）。
结果。在临床无淋巴结转移的颈部，SMND 的区域控制率为 85.2%，MRND 为 83.3%（P=0.89），5 年 DSS 率分别为 86.5%和 87.0%（P=0.94）。在临床 N1 颈部，SMND 的区域控制率为 81.3%，RND 为 83.0%（P=0.72），DSS 率分别为 81.3%和 80.0%（P=0.94）。
无论在单因素或多因素分析中，采用 Cox 比例风险模型，颈部解剖术的类型与区域控制或 DSS 均无显著相关性。
结论。SMND 可有效地应用于临床评估为 N0 或 N1 颈 I 水平的 OSCC 患者的选择性和治疗性管理。
