Li Meng, Cao Hua, Sun Huiru
Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Feb;27(3):113-6.
To summarize the effect of different treatment of cervical lymph node on the prognosis of patients with clinically negative neck (cN0) supraglottic laryngeal carcinoma (SGLC), and to explore the significance of selective neck dissection of levels II, III and(or) IV on SGLC patients with cN0 neck.
A retrospective analysis was undertaken for 83 supraglottic laryngeal squamous cell carcinoma patients with cNo from January 2003 to May 2007 at the Department of Otolaryngology, First Affiliated Hospital of Zhengzhou University. All medical records was complete and all primary tumor were resected by surgery, the follow-up time was at least 5 years or until patients died. The patients' five year survival rate was compared between the selective neck dissection group and other three groups (neck radiotherapy group, combined therapy group and 'wait and see' policy group).
The rate of cervical lymph node metastasis of cN0 supraglottic carcinoma patients with cN0 neck was 30.77%, and with the increasing of T stage, the rate of cervical lymph node metastasis increased gradually. The cervical lymph node recurrence rate of intervention groups was significantly lower than that of 'wait and see' group (P < 0.05). No significant difference (P > 0.05) of 5-year survival rate between selective neck dissection group, neck radiotherapy group, combined therapy group was observed, the difference was significant between selective neck dissection group and observation group (P < 0.05).
Selective neck dissection is one of effective measures to process neck lymph node for cN0 SGLC clinically.
总结不同的颈部处理方式对临床颈部阴性(cN0)声门上型喉癌(SGLC)患者预后的影响,探讨Ⅱ、Ⅲ和(或)Ⅳ区选择性颈清扫术对cN0颈部的SGLC患者的意义。
对2003年1月至2007年5月在郑州大学第一附属医院耳鼻咽喉科收治的83例cN0声门上型喉鳞状细胞癌患者进行回顾性分析。所有病历资料完整,所有原发肿瘤均行手术切除,随访时间至少5年或直至患者死亡。比较选择性颈清扫组与其他三组(颈部放疗组、综合治疗组和“观察等待”组)患者的五年生存率。
cN0颈部的cN0声门上型癌患者颈部淋巴结转移率为30.77%,且随着T分期的增加,颈部淋巴结转移率逐渐升高。干预组的颈部淋巴结复发率明显低于“观察等待”组(P<0.05)。选择性颈清扫组、颈部放疗组、综合治疗组之间的五年生存率无显著差异(P>0.05),选择性颈清扫组与观察组之间差异有统计学意义(P<0.05)。
选择性颈清扫术是临床上处理cN0 SGLC颈部淋巴结的有效措施之一。