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头颈部癌行颈清扫术治疗后复发患者淋巴结比率的预后分析。

Prognostic analysis of lymph node ratio of patients with disease recurrence previously submitted to cervical dissection surgery for head and neck cancer.

机构信息

- Pontifícia Universidade Católica de Campinas, Cirurgia de Cabeça e Pescoço - Campinas - SP - Brasil.

出版信息

Rev Col Bras Cir. 2022 Jun 1;49:e20223178. doi: 10.1590/0100-6991e-20223178-en. eCollection 2022.

Abstract

INTRODUCTION

the variable lymph node ratio has recently been studied as a possible influencer in the survival of patients diagnosed with head and neck cancer.

OBJECTIVE

to analyze the correlation between lymph node density and survival of recurred disease patients previously submitted to cervical dissection surgery due to head and neck squamous cell carcinoma.

METHOD

we retrospectively analyzed 71 medical records of patients treated at the Head and Neck Surgery Service of the Pontifícia Universidade Católica de Campinas who had undergone cervical dissection surgery and presented tumor recurrence between 2006 and 2019. Patient and tumor data such as age, gender, skin color, smoking, alcohol consumption, location of the primary tumor, anatomopathological characteristics and lymph node status were correlated with the survival time.

RESULTS

we found a predominance of males and the mean age was 59.5 years. The most frequent primary site was the oral cavity followed by the larynx and oropharynx. The mortality rate was 53.52% and the mean lymph node ratio 0.28. We found influence on survival with statistical significance for the parameters: lymph node ratio, number of dissected and affected lymph nodes, T and N staging, type of treatment proposed (palliative or surgical), presence of compromited margins in the primary tumor and lymph node extravasation.

CONCLUSION

the calculation of lymph node density in patients with recurred disease after cervical dissection surgery by head and neck squamous cell carcinoma should be taken into account during therapeutic planning and prognostic evaluation due to its direct influence on the survival.

摘要

简介

淋巴结比率的变化最近被研究为影响头颈部癌症患者生存的一个可能因素。

目的

分析头颈部鳞状细胞癌患者行颈清扫术后复发患者的淋巴结密度与生存的相关性。

方法

我们回顾性分析了 2006 年至 2019 年间在坎皮纳斯天主教大学头颈部外科服务处接受颈清扫术且肿瘤复发的 71 例患者的病历。将患者和肿瘤数据(如年龄、性别、肤色、吸烟、饮酒、原发肿瘤部位、解剖病理学特征和淋巴结状态)与生存时间相关联。

结果

我们发现男性居多,平均年龄为 59.5 岁。最常见的原发部位是口腔,其次是喉和口咽。死亡率为 53.52%,平均淋巴结比率为 0.28。我们发现,淋巴结比率、切除和受影响的淋巴结数量、T 和 N 分期、所提议的治疗方法(姑息性或手术性)、原发肿瘤边缘受累情况和淋巴结外渗等参数对生存有统计学意义的影响。

结论

由于淋巴结密度直接影响生存,对头颈部鳞状细胞癌患者行颈清扫术后复发患者的淋巴结密度进行计算,应在治疗计划和预后评估中考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71fc/10578812/05123ea56801/rcbc-49-e20223178-g001.jpg

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