下颌腺癌淋巴结转移的发生率和转移模式。
Incidence and spread pattern of lymph node metastasis from submandibular gland cancer.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan.
Department of Otolaryngology-Head and Neck Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264, Kamiya-Cho, Himeji, Hyogo, 670-8560, Japan.
出版信息
Eur Arch Otorhinolaryngol. 2023 Sep;280(9):4233-4238. doi: 10.1007/s00405-023-08020-x. Epub 2023 May 22.
OBJECTIVES
To clarify the indication of neck dissection (ND) for patient with submandibular gland (SMG) cancer.
METHODS
A total of 43 patients with SMG cancer were retrospectively analyzed. Forty-one patients underwent ND: Levels I-V in 19 patients, Levels I-III in 18 patients, and Level Ib in 4 patients. The other two patients did not undergo ND, since preoperative diagnoses were benign. Postoperative radiotherapy was performed in 19 patients with positive surgical margin, high grade cancer or stage IV disease.
RESULTS
LN metastases were pathologically confirmed in all patients with cN + and 6 out of 31 patients with cN-. No patients developed regional recurrence during follow-up periods. Ultimately, LN metastases were pathologically confirmed in 17 of 27 high grade, one out of 9 intermediate grade, but not in 7 low grade.
CONCLUSIONS
Prophylactic neck dissection should be considered in T3/4 and high grade SMG cancers.
目的
明确颌下腺癌行颈清扫术（ND）的适应证。
方法
回顾性分析 43 例颌下腺癌患者。41 例行 ND：19 例行Ⅰ-Ⅴ区清扫，18 例行Ⅰ-Ⅲ区清扫，4 例行 Ib 区清扫。另 2 例因术前诊断为良性未行 ND。19 例切缘阳性、高级别癌症或 IV 期疾病患者行术后放疗。
结果
所有 cN⁺患者和 31 例 cN⁻患者中有 LN 转移均经病理证实。随访期间无患者出现区域性复发。最终，27 例高级别、9 例中级别和 7 例低级别肿瘤中有 17 例、1 例和 0 例证实存在 LN 转移。
结论
T3/4 和高级别颌下腺癌应考虑预防性颈清扫术。
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