头颈部鳞状细胞癌颈部转移瘤外科治疗的当前理念
Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma.
作者信息
Coskun H Hakan, Medina Jesus E, Robbins K Thomas, Silver Carl E, Strojan Primož, Teymoortash Afshin, Pellitteri Phillip K, Rodrigo Juan P, Stoeckli Sandro J, Shaha Ashok R, Suárez Carlos, Hartl Dana M, de Bree Remco, Takes Robert P, Hamoir Marc, Pitman Karen T, Rinaldo Alessandra, Ferlito Alfio
机构信息
Department of Otolaryngology-Head and Neck Surgery, Uludag University School of Medicine, Bursa, Turkey.
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
出版信息
Head Neck. 2015 Jun;37(6):915-26. doi: 10.1002/hed.23689. Epub 2014 Jun 30.
Abstract
Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.
摘要
颈部清扫术是治疗上消化道癌转移的重要手段；这一情况会显著降低生存率。自该手术开展以来，其理念已从激进主义发生了重大转变，发展为当前的保守方法。此外，非手术方式已被引入，并且在许多情况下，已取代了颈部手术。基于颈部区域受累概念的颈部成像技术的改进促使新的理念不断发展，这些理念似乎有利于改善患者的治疗效果，特别是在降低发病率方面。本综述的目的是强调采用循证方法进行颈部转移瘤手术切除的新范式。
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