cT3-4N0 期腮腺癌患者行择区性颈清扫术是否必要？
Is elective neck dissection necessary for patients with cT3-4N0 parotid gland cancer?
机构信息
Department of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan.
Department of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan.
出版信息
Auris Nasus Larynx. 2022 Oct;49(5):856-861. doi: 10.1016/j.anl.2022.03.010. Epub 2022 Mar 26.
OBJECTIVE
Management of the cervical lymph nodes in patients with cT3-4N0 parotid gland cancer (PGC) has been controversial. This study investigated the need for elective neck dissection (END) in patients with cT3-4N0 PGC.
METHODS
We retrospectively examined cervical lymph node metastasis, overall survival (OS), and disease-free survival (DFS) rates in 40 patients with cT3-4N0 PGC according to whether or not END was performed.
RESULTS
Cervical lymph node metastasis occurred in 27.5% of patients and level II was the most common area. Recurrence could be treated by salvage neck dissection. There was no significant difference in OS (P=0.581) or DFS (P=0.728) between the group that underwent END and the group that did not.
CONCLUSION
END at level II is worth performing because of the occult lymph node metastasis rate. The area of neck dissection should be limited because there is no evidence that END improves the prognosis of cT3-4N0 PGC.
目的
cT3-4N0 腮腺癌（PGC）患者颈部淋巴结的处理一直存在争议。本研究旨在探讨 cT3-4N0 PGC 患者行选择性颈部清扫术（END）的必要性。
方法
我们回顾性分析了 40 例 cT3-4N0 PGC 患者的颈部淋巴结转移、总生存（OS）和无病生存（DFS）率，根据是否行 END 进行分组。
结果
27.5%的患者发生颈部淋巴结转移，最常见的转移部位为 II 区。复发患者可通过挽救性颈部清扫术治疗。行 END 组与未行 END 组的 OS（P=0.581）或 DFS（P=0.728）差异均无统计学意义。
结论
由于隐匿性淋巴结转移率，行 II 区 END 是值得的。颈部清扫术的范围应有限，因为没有证据表明 END 能改善 cT3-4N0 PGC 的预后。
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