Servicio de Otorrinolaringología. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):883-889. doi: 10.1007/s00405-021-06819-0. Epub 2021 May 3.
The objective of this study is to assess the prognostic capacity of the nodal yield in elective neck dissections performed in patients with head and neck squamous cell carcinomas (HNSCC) without clinical or radiological evidence of regional involvement (cN0) at the time of diagnosis.
Retrospective study including 647 patients with HNSCC treated with an elective neck dissection.
Patients with < 15 dissected nodes (n = 172, 26.6%) had a 5-year disease-specific survival of 64.9% (95% CI: 57.3-72.5%), while for patients with ≥ 15 dissected nodes (n = 475, 73.4%), it was of 81.9% (95% CI: 78.4-85.4%) (P = 0.0001). The nodal yield category had prognostic capacity on the disease-specific survival in patients with tumors located in the oral cavity (P = 0.001), the oropharynx (P = 0.023) and the hypopharynx (P = 0.034), while for patients with tumors located in the larynx, no significant differences appeared (P = 0.779). Differences in regional recurrence-free survival were also observed based on the nodal yield category in patients with extra-laryngeal tumors (5-year regional recurrence-free survival of 81.0% in patients with < 15 dissected nodes vs 89.0% in patients with ≥ 15 dissected nodes; P = 0.046).
The nodal yield in elective neck dissections in patients without evidence of lymph node disease (cN0) had prognostic capacity depending on the location of the primary tumor. For tumors located in the larynx, the number of dissected nodes did not significantly influence the prognosis. For tumors located in the oral cavity, oropharynx or hypopharynx, patients with < 15 dissected nodes had a disease-specific mortality 2.9 times higher than patients with ≥ 15 dissected nodes.
本研究旨在评估在诊断时无局部区域受累（cN0）的头颈部鳞状细胞癌（HNSCC）患者中进行选择性颈部清扫术时的淋巴结检出量对预后的预测能力。
回顾性研究纳入 647 例接受选择性颈部清扫术的 HNSCC 患者。
淋巴结检出数＜15 枚的患者（n=172，26.6%）5 年疾病特异性生存率为 64.9%（95%CI：57.3-72.5%），而淋巴结检出数≥15 枚的患者（n=475，73.4%）为 81.9%（95%CI：78.4-85.4%）（P=0.0001）。肿瘤位于口腔（P=0.001）、口咽（P=0.023）和下咽（P=0.034）的患者中，淋巴结检出量分类对疾病特异性生存率有预后能力，而位于喉的患者则无显著差异（P=0.779）。对于外喉肿瘤患者，基于淋巴结检出量分类，也观察到区域无复发生存率的差异（淋巴结检出数＜15 枚的患者 5 年区域无复发生存率为 81.0%，淋巴结检出数≥15 枚的患者为 89.0%；P=0.046）。
在无淋巴结疾病证据（cN0）的患者中进行的选择性颈部清扫术的淋巴结检出量具有预后能力，这取决于原发肿瘤的位置。对于位于喉的肿瘤，淋巴结检出数对预后无显著影响。对于位于口腔、口咽或下咽的肿瘤，淋巴结检出数＜15 枚的患者疾病特异性死亡率是淋巴结检出数≥15 枚的患者的 2.9 倍。
