Kuscu Oguz, Bajin Munir Demir, Süslü Nilda, Hoşal Ali Şefik
Hacettepe University, Department of Otorhinolaryngology, Head and, Neck Surgery, Turkey.
Liv Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Turkey.
J Craniomaxillofac Surg. 2016 Sep;44(9):1404-7. doi: 10.1016/j.jcms.2016.06.004. Epub 2016 Jun 18.
To evaluate the efficacy of L1-2ND in the management of the lower lip squamous cell carcinoma and to achieve the highest cure rates with adequate neck dissection.
A retrospective review was completed on patients treated between 1994 and 2014. The case histories of 184 patients who were treated with surgical excision of the primary tumor along with neck dissection, and 24 patients who were treated only with surgical excision without neck dissection at another center, were studied. All patients were followed up for evidence of recurrent disease.
In 208 patients (193 men, 15 women) with a mean age of 51 years, 12 were N1, 3 were N2, and 169 were N0; 24 patients had undergone operation at another center without neck dissection. Lymph node metastases were present in 34 patients (18.4%) with dissected necks and occult metastases were detected in 19 patients with clinically N0 necks (11.2%). The median follow-up of each patient was 28 months. Only 1 patient developed neck recurrence, and there was no local recurrence. The overall survival rate (OAS) of patients with clinical N0 disease who underwent neck dissection was 94.7%; the OAS of the patients who were not treated with neck dissection was 29.1%.
Level 1-2 neck dissection (L1-2ND) is the treatment of choice for controlling neck disease in patients with lower lip carcinoma, and serves as a staging procedure to detect patients who require adjuvant therapy.
评估L1 - 2颈部清扫术(L1 - 2ND)治疗下唇鳞状细胞癌的疗效,并通过充分的颈部清扫术实现最高治愈率。
对1994年至2014年间接受治疗的患者进行回顾性研究。研究了184例接受原发肿瘤手术切除并同时进行颈部清扫术的患者,以及24例在另一中心仅接受手术切除而未进行颈部清扫术的患者的病历。对所有患者进行随访以寻找疾病复发的证据。
208例患者(193例男性,15例女性),平均年龄51岁,其中12例为N1,3例为N2,169例为N0;24例患者在另一中心接受了未进行颈部清扫术的手术。在进行颈部清扫术的患者中,34例(18.4%)出现淋巴结转移,在临床N0颈部的19例患者中检测到隐匿性转移(11.2%)。每位患者的中位随访时间为28个月。仅1例患者出现颈部复发,无局部复发。接受颈部清扫术的临床N0疾病患者的总生存率(OAS)为94.7%;未接受颈部清扫术的患者的OAS为29.1%。
1 - 2级颈部清扫术(L1 - 2ND)是控制下唇癌患者颈部疾病的首选治疗方法,也是检测需要辅助治疗患者的分期程序。