T1和T2期口腔鳞状细胞癌及cN0pN（+）颈部患者的选择性与根治性颈淋巴结清扫术
Selective Versus Comprehensive Neck Dissection in Patients With T1 and T2 Oral Squamous Cell Carcinoma and cN0pN(+) Neck.
作者信息
Liang Li-Zhong, Liu Xiang-Qi, Kong Qian-Ying, Liao Gui-Qing
机构信息
Resident, Department of Oral and Maxillofacial Surgery, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Resident, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
出版信息
J Oral Maxillofac Surg. 2016 Jun;74(6):1271-6. doi: 10.1016/j.joms.2016.01.001. Epub 2016 Jan 7.
PURPOSE
There is still no consensus on the oncologic safety of selective neck dissection (SND) in the management of pathologically positive neck in patients with oral squamous cell carcinoma (OSCC). This study compared the clinical outcome between SND and comprehensive neck dissection (CND) for patients with T1 and T2 OSCC and a clinically negative but pathologically positive neck.
MATERIALS AND METHODS
Retrospective study of medical records of patients with T1 and T2 OSCC and clinical N0 but pathologic N(+) disease from March 2000 through March 2011 was performed. Thirty-seven patients underwent SND or CND. Median follow-up was 51 months. Regional control and disease-specific survival rates were statistically analyzed.
RESULTS
No significant differences in 3-year ipsilateral neck control rate (81.8 vs 91.7%; P = .590 by log-rank test) and overall regional control rate (72.7 vs 86.8%; P = .424 by log-rank test) were found between the SND and CND groups. Three-year disease-specific survival rates of the SND and CND groups were 72.7 and 82.1%, respectively. No significant difference was found between these 2 groups by log-rank test (P = .428).
CONCLUSIONS
The results indicate that SND in conjunction with postoperative radiotherapy is effective in the management of patients with T1 and T2 OSCC and cN0pN(+) neck.
目的
在口腔鳞状细胞癌（OSCC）患者颈部病理检查呈阳性的治疗中，对于选择性颈清扫术（SND）的肿瘤学安全性仍未达成共识。本研究比较了T1和T2期OSCC且颈部临床检查为阴性但病理检查为阳性的患者接受SND和根治性颈清扫术（CND）后的临床结局。
材料与方法
对2000年3月至2011年3月期间T1和T2期OSCC且临床N0但病理N（+）疾病患者的病历进行回顾性研究。37例患者接受了SND或CND。中位随访时间为51个月。对区域控制率和疾病特异性生存率进行了统计学分析。
结果
SND组和CND组之间的3年同侧颈部控制率（81.8%对91.7%；对数秩检验P = 0.590）和总体区域控制率（72.7%对86.8%；对数秩检验P = 0.424）无显著差异。SND组和CND组的3年疾病特异性生存率分别为72.7%和82.1%。对数秩检验显示这两组之间无显著差异（P = 0.428）。
结论
结果表明，SND联合术后放疗在T1和T2期OSCC以及cN0pN（+）颈部患者的治疗中是有效的。
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