舌骨上颈部清扫术对cT1/T2期舌癌的疾病控制效果
Adequacy of Disease Control by Supraomohyoid Neck Dissection in cT1/T2 Tongue Cancer.
作者信息
Iandelli Andrea, Marchi Filippo, Chen An-Chieh, Young Chi-Kuan, Liao Chun-Ta, Tsao Chung-Kan, Kang Chung-Jan, Wang Hung-Ming, Chang Tung-Chieh Joseph, Huang Shiang-Fu
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Branch, Yaoyuan 33302, Taiwan.
Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
出版信息
J Pers Med. 2022 Sep 19;12(9):1535. doi: 10.3390/jpm12091535.
BACKGROUND
Patients affected by oral tongue squamous cell carcinoma (OTSCC) underwent a supraomohyoid neck dissection (SOHND) or modified radical neck dissection (mRND) according to the clinical nodal status (cN0 vs. cN+). We investigate whether the type of neck dissection affects survival with the presence of extranodal extension (ENE) and multiple nodal metastases (MNM).
METHODS
We conducted a retrospective study enrolling surgically treated patients affected by cT1/T2 OTSCC and MNM or ENE. The outcomes assessed were: overall survival (OS), disease-free survival (DFS), and neck-control- and metastases-free survival (NC-MFS). Survival curves were plotted by the Kaplan-Meier method and the log-rank test. Furthermore, we conducted a multivariable analysis with the Cox regression model.
RESULTS
We included a total of 565 patients (36% cT1, 64% cT2). Of these, 501 patients underwent a SOHND, and 64 underwent an mRND. A total of 184 patients presented rpN+, with 28.7% of these in the SOHND group and 62.5% of these in the mRND group. We identified no significant differences in OS, DFS, and NC-MFS in the whole pN+ cohort, in the MNM, and the ENE subgroups. In the multivariable analysis, the type of ND did not affect OS and DFS.
CONCLUSIONS
Treating cT1-2 N0/+ tongue cancer with SOHND is oncologically safe. ENE and MNM patients do not benefit from an mRND.
背景
口腔舌鳞状细胞癌（OTSCC）患者根据临床淋巴结状态（cN0与cN+）接受肩胛舌骨上颈清扫术（SOHND）或改良根治性颈清扫术（mRND）。我们研究颈清扫术的类型是否会影响存在结外扩展（ENE）和多发淋巴结转移（MNM）时的生存率。
方法
我们进行了一项回顾性研究，纳入接受手术治疗的cT1/T2 OTSCC且伴有MNM或ENE的患者。评估的结果包括：总生存期（OS）、无病生存期（DFS）以及无颈部转移和无远处转移生存期（NC-MFS）。通过Kaplan-Meier法和对数秩检验绘制生存曲线。此外，我们使用Cox回归模型进行多变量分析。
结果
我们共纳入565例患者（36%为cT1，64%为cT2）。其中，501例患者接受了SOHND，64例接受了mRND。共有184例患者出现rpN+，其中SOHND组占28.7%，mRND组占62.5%。我们在整个pN+队列、MNM和ENE亚组的OS、DFS和NC-MFS中未发现显著差异。在多变量分析中，颈清扫术的类型不影响OS和DFS。
结论
用SOHND治疗cT1-2 N0/+舌癌在肿瘤学上是安全的。ENE和MNM患者不能从mRND中获益。
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