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头颈部癌患者接受放化疗后的隐匿性淋巴结转移。

Occult nodal metastasis in head and neck carcinoma patients treated with chemoradiotherapy.

机构信息

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Cancer Research Center, Pathology Department, Babol University of Medical Science, Mazandaran, Iran.

出版信息

Am J Otolaryngol. 2022 Mar-Apr;43(2):103361. doi: 10.1016/j.amjoto.2021.103361. Epub 2021 Dec 24.

Abstract

BACKGROUND AND AIM

Neck lymph node metastasis plays an important role in the prognosis of patients with squamous cell carcinoma of the head and neck. The aim of this study was to evaluate the occult nodal metastasis in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemo radiotherapy.

METHODS

In this 5-year prospective study, patients with recurrent head and neck squamous cell carcinomas (HN-SCC) after primary treatment with chemoradiotherapy or radiotherapy that candidate for surgery were enrolled. In total, 50 patients with squamous cell carcinomas of the head and neck with N0 neck were included in the study. Age, initial location of recurrent tumor, T staging in primary and recurrent tumors, neck condition (N0 or N+), and pathology report for neck metastasis, number of affected lymph nodes and duration of tumor recurrence were examined.

RESULTS

Out of 50 patients with mean age of 57.04 ± 14.4 years, 13 were female (26%) and 37 (74%) were male. In terms of primary tumor size, 52% (26 patients) were in T2 stage. The primary and recurrent tumor was located in the oral cavity in 33 patients (66%). Nine 0f 50 patients (18%) had occult metastases.

CONCLUSION

It seems that END surgery is necessary for treatment the occult lymph node neck metastasis of recurrent head and neck cancers with N0 neck. Therefore, it is possible that END surgery has reduced cervical recurrence in these patients.

摘要

背景与目的

颈部淋巴结转移对头颈鳞状细胞癌患者的预后起着重要作用。本研究旨在评估接受放化疗的头颈部鳞状细胞癌(HNSCC)患者隐匿性淋巴结转移的情况。

方法

在这项为期 5 年的前瞻性研究中,纳入了因放化疗后复发且适合手术的头颈部复发性鳞状细胞癌(HN-SCC)患者。共有 50 例头颈部鳞状细胞癌 N0 颈患者纳入研究。分析患者的年龄、初始肿瘤复发位置、原发和复发肿瘤的 T 分期、颈部情况(N0 或 N+)、颈部转移的病理报告、受影响的淋巴结数量和肿瘤复发时间。

结果

50 例患者的平均年龄为 57.04±14.4 岁,其中 13 例为女性(26%),37 例为男性(74%)。原发肿瘤大小方面,26 例(52%)患者处于 T2 期。原发和复发肿瘤位于口腔的患者有 33 例(66%)。50 例患者中有 9 例(18%)存在隐匿性转移。

结论

对于 N0 颈复发性头颈部癌症隐匿性淋巴结转移患者,似乎需要进行 END 手术。因此,END 手术可能减少了这些患者的颈部复发。

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