Zieske L A, Johnson J T, Myers E N, Thearle P B
Arch Otolaryngol Head Neck Surg. 1986 Aug;112(8):863-6. doi: 10.1001/archotol.1986.03780080063014.
The charts of patients treated surgically for squamous cell carcinoma of the head and neck were reviewed retrospectively to correlate the pathologic report of the adequacy of margins with subsequent treatment and eventual outcome. Three hundred forty-nine patients were studied. Thirty-one patients (8.8%) had positive margins. Positive margins were most commonly encountered in patients with tonsillar and hypopharyngeal lesions. Twenty-nine (94%) of the patients had stage III or IV disease. Two patients (6.4%) remain free of disease 36 months or longer following surgery. Radiation therapy was administered postoperatively to 25 patients. Sixty percent of these patients failed to achieve local-regional control, and 84% are dead of disease. When free margins of resection cannot be obtained due to anatomic limitation, postoperative radiation therapy has been unsatisfactory in our hands. Alternative treatment, such as radiation implants or chemotherapy, would appear to offer the only hope of improving the chances for long-term survival.
对头颈部鳞状细胞癌手术治疗患者的病历进行回顾性分析，以关联切缘充分性的病理报告与后续治疗及最终结果。共研究了349例患者。31例（8.8%）切缘阳性。切缘阳性最常见于扁桃体和下咽病变患者。其中29例（94%）患者为Ⅲ期或Ⅳ期疾病。2例（6.4%）患者术后36个月或更长时间无疾病复发。25例患者术后接受了放射治疗。这些患者中有60%未实现局部区域控制，84%死于疾病。由于解剖学限制无法获得切缘阴性时，在我们的经验中术后放射治疗效果不佳。替代治疗，如放射植入或化疗，似乎是提高长期生存机会的唯一希望。
