Wiegand S, Esters J, Müller H-H, Jäcker T, Roessler M, Fasunla J A, Werner J A, Sesterhenn A M
Department of Otolaryngology, Head and Neck Surgery, Marburg, Germany.
J Laryngol Otol. 2012 Aug;126(8):795-9. doi: 10.1017/S0022215112001077. Epub 2012 Jun 15.
Dissection of neck levels I and IIB is time-consuming and can cause comorbidity. This study aimed to determine whether level I and IIB neck dissection was necessary in patients with laryngeal cancer and clinically detectable or nondetectable neck nodes.
This was a retrospective review of 73 patients with laryngeal cancer. Essential clinical data were obtained and analysed to determine the incidence of neck node metastasis in levels I and IIB.
Of the 48 patients with no clinically apparent neck nodes, none had level I metastases and only one had level IIB metastases. Of the patients with clinically detectable neck nodes, three of 21 patients had level I metastases and three of 25 patients had level IIB metastases; these six patients also had additional metastases in level IIA.
Dissection of neck levels I and IIB is justifiable in laryngeal cancer patients with clinically detectable neck nodes and suspicious lymph nodes in the respective level or level IIA. However, in patients without clinically detectable neck nodes, preservation of levels I and IIB is oncologically safe, economical and reduces the risk of comorbidity.
颈部I区和IIB区清扫耗时且可能导致合并症。本研究旨在确定对于喉癌患者以及临床上可检测到或未检测到颈部淋巴结的患者，I区和IIB区颈部清扫是否必要。
这是一项对73例喉癌患者的回顾性研究。获取并分析重要临床数据，以确定I区和IIB区颈部淋巴结转移的发生率。
在48例临床上无明显颈部淋巴结的患者中，无一例发生I区转移，仅1例发生IIB区转移。在临床上可检测到颈部淋巴结的患者中，21例中有3例发生I区转移，25例中有3例发生IIB区转移；这6例患者在IIA区也有其他转移。
对于临床上可检测到颈部淋巴结且相应区域或IIA区有可疑淋巴结的喉癌患者，I区和IIB区清扫是合理的。然而，对于临床上未检测到颈部淋巴结的患者，保留I区和IIB区在肿瘤学上是安全的、经济的，并且可降低合并症风险。
