双侧颈部失败口腔舌癌：两个中心使用预设治疗标准的结果。

Contralateral neck failure in oral tongue cancer: Outcomes from two centers using predefined treatment criteria.

机构信息

Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia.

出版信息

Head Neck. 2021 Jul;43(7):2024-2031. doi: 10.1002/hed.26671. Epub 2021 Mar 17.

DOI:10.1002/hed.26671

PMID:33729633

Abstract

BACKGROUND

The objective was to determine the incidence of, and factors associated with contralateral neck failure (CNF) in oral tongue squamous cell carcinoma (OTSCC).

METHODS

Consecutive patients with OTSCC between 2007 and 2016 were included. The predefined policy of the contralateral neck included neck dissection (ND) where the primary tumor extended/crossed midline or the contralateral neck was involved; and elective nodal irradiation (ENI) where the primary tumor was ≤1 cm from midline/2 cm from tip.

RESULTS

This study included 258 patients. ND was ipsilateral 169 (66%) and bilateral 33 (13%). Fifty-five patients (21%) received ENI to the undissected contralateral neck. CNF occurred in 19 patients (7%) and was similar by treatment received. Utilizing this approach, we observed higher rates of CNF with increasing N classification, perineural invasion, extracapsular extension, and depth of invasion ≥6 mm.

CONCLUSIONS

Using our institutional policy of treatment to the contralateral neck, a low rate of CNF (≤10%) was observed.

摘要

背景

本研究旨在确定口腔舌鳞状细胞癌（OTSCC）中对侧颈部失败（CNF）的发生率和相关因素。

方法

连续纳入 2007 年至 2016 年间的 OTSCC 患者。对侧颈部的预设策略包括：原发肿瘤延伸/穿过中线或对侧颈部受累时行颈清扫术（ND）；原发肿瘤距中线≤1cm/距尖端 2cm 时行选择性淋巴结照射（ENI）。

结果

本研究纳入 258 例患者。ND 为同侧 169 例（66%），双侧 33 例（13%）。55 例（21%）患者对未行手术清扫的对侧颈部行 ENI。19 例（7%）患者发生 CNF，与治疗方式无关。采用这种方法，我们观察到 CNF 的发生率随着 N 分类、神经周围侵犯、囊外扩展和浸润深度≥6mm 的增加而升高。