Park S W, Eade T, Pang L, Wignall A, Veivers D
Department of Otolaryngology Head and Neck Surgery,Royal North Shore Hospital,Sydney,Australia.
Northern Clinical School,University of Sydney,Australia.
J Laryngol Otol. 2016 Jul;130 Suppl 4:S54-9. doi: 10.1017/S0022215116008343.
To investigate the rate of occult neck disease in patients with metastatic squamous cell carcinoma to the parotid gland following parotidectomy and neck dissection.
A consecutive series of patients treated between 2000 and 2014 for metastatic squamous cell carcinoma to the parotid were analysed. Patients were included if they had no clinical or radiological evidence of neck disease. Pathology of parotidectomy and neck dissection specimens was reviewed. Other variables analysed included patient immune status, surgery type, complications, use of positron emission tomography scanning and treatment with radiotherapy.
Sixty-five patients had no clinical or radiological evidence of neck disease initially. Forty-six patients (70.8 per cent) underwent neck dissection. Occult neck disease was only found in 8 of the 46 patients (17.3 per cent). Occult neck disease was found more often in those with immunocompromise (5.7 vs 38.5 per cent, p = 0.003). Patients who were immunocompromised had a significantly worse disease-specific survival rate at five years (0 vs 92 per cent, p = 0.0001).
Occult neck disease was seen in 17.3 per cent of patients and immunosuppression was a significant predictor for this.
研究腮腺转移性鳞状细胞癌患者腮腺切除及颈清扫术后隐匿性颈部疾病的发生率。
分析2000年至2014年间连续治疗的腮腺转移性鳞状细胞癌患者。若患者无颈部疾病的临床或影像学证据，则纳入研究。回顾腮腺切除术和颈清扫术标本的病理情况。分析的其他变量包括患者免疫状态、手术类型、并发症、正电子发射断层扫描的使用情况以及放疗治疗情况。
65例患者最初无颈部疾病的临床或影像学证据。46例患者（70.8%）接受了颈清扫术。46例患者中仅8例（17.3%）发现隐匿性颈部疾病。免疫功能低下者隐匿性颈部疾病的发生率更高（5.7%对38.5%，p = 0.003）。免疫功能低下的患者五年疾病特异性生存率明显更低（0对92%，p = 0.0001）。
17.3%的患者出现隐匿性颈部疾病，免疫抑制是其重要预测因素。
