Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
University of Cambridge, Cambridge, UK.
Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5573-5581. doi: 10.1007/s00405-022-07399-3. Epub 2022 May 13.
Primary: To determine the rate of occult cervical metastases in primary temporal bone squamous cell carcinomas (TBSSC). Secondary: to perform a subgroup meta-analysis of the risk of occult metastases based on the clinical stage of the tumour and its risk based on corresponding levels of the neck.
A systematic review and meta-analysis of papers searched through Medline, Cochrane, Embase, Scopus and Web of Science up to November 2021 to determine the pooled rate of occult lymph node/parotid metastases. Quality assessment of the included studies was assessed through the Newcastle-Ottawa scale.
Overall, 13 out of 3301 screened studies met the inclusion criteria, for a total of 1120 patients of which 550 had TBSCC. Out of the 267 patients who underwent a neck dissection, 33 had positive lymph nodes giving a pooled rate of occult metastases of 14% (95% CI 10-19%). Occult metastases rate varied according to Modified Pittsburg staging system, being 0% (0-16%) among 12 pT1, 7% (2-20%) among 43 pT2 cases, 21% (11-38%) among 45 pT3, and 18% (11-27%) among 102 pT4 cases. Data available showed that most of the positive nodes were in Level II.
The rate of occult cervical metastases in TBSCC increases with pathological T category with majority of nodal disease found in level II of the neck.
主要目的是确定原发性颞骨鳞状细胞癌(TBSSC)中隐匿性颈部转移的发生率。次要目的是基于肿瘤的临床分期和相应颈部水平的风险,对隐匿性转移的风险进行亚组荟萃分析。
通过 Medline、Cochrane、Embase、Scopus 和 Web of Science 系统检索文献,对截至 2021 年 11 月的文献进行综述和荟萃分析,以确定隐匿性淋巴结/腮腺转移的总发生率。通过纽卡斯尔-渥太华量表评估纳入研究的质量。
共有 13 项研究符合纳入标准,总共纳入 1120 例患者,其中 550 例为 TBSSC。在接受颈部清扫术的 267 例患者中,有 33 例有阳性淋巴结,隐匿性转移的总发生率为 14%(95%CI 10-19%)。隐匿性转移率根据改良 Pittsburg 分期系统而有所不同,12 例 pT1 患者中为 0%(0-16%),43 例 pT2 患者中为 7%(2-20%),45 例 pT3 患者中为 21%(11-38%),102 例 pT4 患者中为 18%(11-27%)。现有数据显示,大多数阳性淋巴结位于 II 区。
TBSSC 隐匿性颈部转移的发生率随着病理 T 分期的增加而增加,淋巴结疾病主要位于颈部 II 区。