临床 N1 期口腔癌患者颈部淋巴结清扫术的范围。
Extent of neck dissection for patients with clinical N1 oral cancer.
机构信息
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Otolaryngology, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
Int J Clin Oncol. 2020 Jun;25(6):1067-1071. doi: 10.1007/s10147-020-01635-8. Epub 2020 Mar 5.
Abstract
BACKGROUND
No clear consensus has been reached on the indication of supraomohyoid neck dissection (SOHND) for clinically positive lymph-node metastasis.
PATIENTS
Consecutive 100 patients with previously untreated oral cancer treated at Kobe University Hospital were included in this study. All patients were clinically staged as anyTN1M0 and underwent radical dissection of the primary site and level I-V neck dissection as the initial treatment.
RESULTS
None of the 100 patients had pathological lymph-node metastasis (pLN) to level V. pLN to level IV was observed in two patients with tongue cancer in whom clinical lymph-node metastasis was preoperatively observed at level II.
CONCLUSIONS
Level V may be excluded in the neck dissection for patients with N1 oral cancers. Level IV dissection should be considered in the patient with tongue cancer and clinical lymph-node metastasis at level II.
摘要
背景
对于临床阳性淋巴结转移的患者，行上颈清扫术（SOHND）的适应证尚无明确共识。
患者
本研究纳入了在神户大学医院接受治疗的 100 例先前未经治疗的口腔癌连续患者。所有患者的临床分期均为任何 T1N1M0，并接受了原发灶根治性切除术和 I-V 颈清扫术作为初始治疗。
结果
100 例患者中均无病理学淋巴结转移（pLN）至 V 水平。2 例舌癌患者中观察到 pLN 至 IV 水平，这 2 例患者术前临床淋巴结转移位于 II 水平。
结论
对于 N1 口腔癌患者，可排除 V 水平的颈清扫术。对于舌癌和 II 水平临床淋巴结转移的患者，应考虑行 IV 水平清扫术。
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