Jouhi Lauri, Atula Timo, Mäkitie Antti, Keski-Säntti Harri
Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, P.O. Box 263, 00029 HUS, Helsinki, Finland.
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.
Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1205-1210. doi: 10.1007/s00405-019-05314-x. Epub 2019 Feb 7.
Only a minority of patients with oropharyngeal squamous cell carcinoma (OPSCC) are diagnosed without regional metastasis (cN0). Studies focusing on the management of cN0 neck in OPSCC are scarce.
We reviewed all OPSCC patients treated at our institution with cN0 neck between 2000 and 2009. The treatment of neck and pattern of regional control was analyzed. Median follow-up was 5 years (range 3.5-9.0) or until death.
Of the total 313 OPSCC patients treated within the period, 56 (18%) presented with cN0 neck. Of them, 51 (91%) received completed treatment with curative intent: 46 (90%) underwent elective neck treatment with either neck dissection ± (chemo)radiotherapy (C)RT (n = 23) or (C)RT (n = 23). A regional recurrence occurred in three patients (6%) and they all had a p16-negative soft palate midline primary tumor. Two of these patients had received RT on the neck.
While the overall prognosis of OPSCC is generally favorable and regional recurrences are infrequent, soft palate tumors, that are usually p16 negative, may form an subgroup warranting more aggressive treatment despite the clinical appearance of early stage.
仅有少数口咽鳞状细胞癌（OPSCC）患者在诊断时无区域转移（cN0）。针对OPSCC中cN0颈部处理的研究较少。
我们回顾了2000年至2009年间在我院接受治疗的所有cN0颈部的OPSCC患者。分析了颈部治疗及区域控制模式。中位随访时间为5年（范围3.5 - 9.0年）或直至死亡。
在此期间治疗的313例OPSCC患者中，56例（18%）表现为cN0颈部。其中，51例（91%）接受了根治性的完整治疗：46例（90%）接受了选择性颈部治疗，包括颈部清扫±（化疗）放疗（C）RT（n = 23）或（C）RT（n = 23）。3例患者（6%）出现区域复发，他们均患有p16阴性的软腭中线原发性肿瘤。其中2例患者颈部接受了放疗。
虽然OPSCC的总体预后通常较好且区域复发不常见，但通常为p16阴性的软腭肿瘤可能构成一个亚组，尽管临床外观为早期，仍需要更积极的治疗。
