Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA.
Department of Biostatistics and Center for Statistical Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA.
Otolaryngol Head Neck Surg. 2021 Jun;164(6):1230-1239. doi: 10.1177/0194599820969104. Epub 2020 Nov 24.
FDG-PET/CT (fluorodeoxyglucose-positron emission tomography/computed tomography) is effective to assess for occult neck nodal disease. We report risks and patterns of nodal disease based on primary site and nodal level from data on the dissected cN0 per the results from ACRIN 6685.
Prospective nonrandomized enrollment included participants with first-time head and neck squamous cell carcinoma and at least 1 cN0 neck side to be dissected.
Twenty-four ACRIN-certified centers internationally (American College of Radiology Imaging Network).
A total of 287 participants were enrolled. Preoperative FDG-PET/CT findings were centrally reviewed and compared with pathology. Incidence, relative risk, pattern of lymph node involvement, and impact upon neck dissection were reported.
An overall 983 nodal levels were dissected (n = 261 necks, n = 203 participants). The highest percentages of ipsilateral positive nodes by primary location and nodal level were oral cavity (level I, 17/110, 15.5%), pharynx (level II, 6/30, 20.0%), and larynx (level VI, 1/3, 33.3%).
Levels at greatest risk for nodal disease in cN0 in terms of ipsilateral neck dissection are level I (oral cavity), II (pharynx), and VI (larynx). These data should be considered when treating patients presenting with cN0. This is the first study to comprehensively report the incidence, location, and risk of metastases in cN0 in the FDG-PET/CT era.
FDG-PET/CT（氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描）可有效评估隐匿性颈部淋巴结疾病。我们根据 ACRIN 6685 的结果报告了基于原发部位和淋巴结水平的 cN0 中淋巴结疾病的风险和模式。
前瞻性非随机入组包括首次头颈部鳞状细胞癌且至少有 1 个 cN0 颈部侧区需要解剖的患者。
24 个国际 ACRIN 认证中心（美国放射学院成像网络）。
共入组 287 名患者。术前 FDG-PET/CT 结果由中心进行审查并与病理结果进行比较。报告了发病率、相对风险、淋巴结受累模式以及对颈部解剖的影响。
总共解剖了 983 个淋巴结水平（n=261 个颈部，n=203 名患者）。根据原发部位和淋巴结水平，同侧阳性淋巴结的百分比最高的是口腔（I 级，17/110，15.5%）、咽（II 级，6/30，20.0%）和喉（VI 级，1/3，33.3%）。
就同侧颈部解剖而言，cN0 中淋巴结疾病风险最高的水平是 I 级（口腔）、II 级（咽）和 VI 级（喉）。在治疗 cN0 患者时应考虑这些数据。这是第一项在 FDG-PET/CT 时代全面报告 cN0 中淋巴结转移发生率、位置和风险的研究。
