行全喉切除术和颈淋巴结清扫术患者的淋巴结检出数的影响。
Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection.
机构信息
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
出版信息
Ann Otol Rhinol Laryngol. 2021 Jun;130(6):591-601. doi: 10.1177/0003489420964824. Epub 2020 Oct 14.
OBJECTIVES
To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY.
METHODS
Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND.
RESULTS
Preoperative RT significantly decreased mean LNY from 31.7 to 23.9 nodes ( < .001). In primary TL patients, age ( < .001) and positive margins ( = .044) were associated with decreased OS. In salvage TL patients, only positive margins was associated with poorer OS ( = .009). No LNY cutoff provided significant OS or DFS benefit.
CONCLUSIONS
Radiotherapy significantly reduces LNY in patients undergoing TL and ND. Within a single institution cohort, positive margins, but not LNY, is associated with survival in both primary and salvage TL patients. 4.
目的
确定在全喉切除术（TL）时行颈清扫术患者的淋巴结检出量（LNY）的影响。确定放射治疗（RT）对 LNY 的影响。
方法
对 232 例接受原发或挽救性全喉切除术（TL）联合颈清扫术（ND）的患者的 LNY 和临床结果进行回顾性分析。
结果
术前 RT 显著降低了平均 LNY，从 31.7 个降至 23.9 个（ < .001）。在原发性 TL 患者中，年龄（ < .001）和阳性切缘（ = .044）与降低的 OS 相关。在挽救性 TL 患者中，仅阳性切缘与较差的 OS 相关（ = .009）。没有 LNY 截断值提供显著的 OS 或 DFS 获益。
结论
放疗显著降低了行 TL 和 ND 的患者的 LNY。在单一机构队列中，阳性切缘而非 LNY，与原发性和挽救性 TL 患者的生存相关。
Zotero 插件