Dabholkar Jyoti Pralhad, Kapre Neeti Madan
KEM Hospital, Mumbai, India ; Cumbala Hill Hospital, Breach Candy Hospital, Mumbai, India.
KEM Hospital, Mumbai, India ; Tata Memorial Hospital, Mumbai, India.
Indian J Surg Oncol. 2016 Sep;7(3):303-6. doi: 10.1007/s13193-015-0461-5. Epub 2015 Sep 16.
Nodal metastases is the most important prognostic marker for oral cavity cancers. Nodal dissection at level IIb risks damage to the spinal accessory nerve. We aim to study positivity of level IIb lymph nodes in oral cancers. In this non-randomized prospective observational study, 65 patients of oral cavity cancers were evaluated. Appropriate surgery for primary tumour and neck dissection were undertaken. All patients underwent level II b dissection. Out of 67 neck dissections (27 elective and 40 therapeutic), 7 patients had level IIb positive for metastases (10.44 %) with no isolated or contralateral metastases at level IIb and direct correlation with level IIa nodes. There was no statistical association of level IIb positivity with stage or site of primary. Level IIb dissection can be avoided in N0 necks. For therapeutic neck dissections, Level IIb should be cleared if there are positive nodes at level IIa.
区域淋巴结转移是口腔癌最重要的预后标志物。IIb 区淋巴结清扫有损伤副神经的风险。我们旨在研究口腔癌患者 IIb 区淋巴结的阳性情况。在这项非随机前瞻性观察研究中，对 65 例口腔癌患者进行了评估。对原发肿瘤进行了适当的手术并进行了颈部清扫。所有患者均接受了 IIb 区清扫。在 67 次颈部清扫中（27 次选择性清扫和 40 次治疗性清扫），7 例患者的 IIb 区淋巴结转移呈阳性（10.44%），IIb 区无孤立或对侧转移，且与 IIa 区淋巴结直接相关。IIb 区阳性与原发肿瘤的分期或部位无统计学关联。N0 颈部可避免进行 IIb 区清扫。对于治疗性颈部清扫，如果 IIa 区有阳性淋巴结，则应清扫 IIb 区。
