Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
Head Neck. 2024 Aug;46(8):1938-1945. doi: 10.1002/hed.27676. Epub 2024 Feb 9.
Our objective is to assess the oncologic outcomes of observation, elective neck dissection (END), and elective neck irradiation (ENI) in the neck management of head and neck cutaneous squamous cell carcinoma (HNcSCC) with parotid metastasis (P+) and to evaluate the quality of life (QoL) of patients who received END or ENI.
Patients with P+ HNcSCC were retrospectively enrolled. The impact of observation, END, and ENI on regional control (RC) and overall survival (OS) was analyzed using Cox proportional hazards model with presentation via hazard ratio (HR) with a 95% confidence interval (CI). QoL was evaluated using the University of Washington Quality of Life questionnaire.
A total of 134 patients were included in our analysis. In the Cox model for RC, both END and ENI had decreased HRs of 0.27 (95% CI: 0.15-0.69) and 0.34 (95% CI: 0.18-0.86), respectively, in comparison with observation. In the Cox model for OS, both END (p = 0.001, HR: 0.22, 95% CI: 0.10-0.72) and ENI (p = 0.006, HR: 0.30, 95% CI: 0.17-0.83) were superior to observation. In patients with three or more positive parotid lymph nodes, END resulted in significantly better RC (p < 0.001) and OS (p = 0.001) compared with ENI. The two groups were found to be comparable in all 12 domains of the University of Washington Quality of Life questionnaire.
In the neck management of P+ HNcSCC, observation is not recommended. END is the preferred option, but ENI is an alternative method without compromise to survival or QoL, except in cases with three or more metastatic parotid lymph nodes.
评估头颈部皮肤鳞状细胞癌（HNcSCC）伴腮腺转移（P+）患者的观察、选择性颈部清扫术（END）和选择性颈部放疗（ENI）在颈部管理中的肿瘤学结局，并评估接受 END 或 ENI 治疗的患者的生活质量（QoL）。
回顾性纳入 P+ HNcSCC 患者。采用 Cox 比例风险模型分析观察、END 和 ENI 对局部控制（RC）和总体生存（OS）的影响，通过风险比（HR）及其 95%置信区间（CI）呈现。使用华盛顿大学生活质量问卷评估 QoL。
共纳入 134 例患者。在 RC 的 Cox 模型中，与观察相比，END 和 ENI 的 HR 分别为 0.27（95%CI：0.15-0.69）和 0.34（95%CI：0.18-0.86），均降低。在 OS 的 Cox 模型中，与观察相比，END（p=0.001，HR：0.22，95%CI：0.10-0.72）和 ENI（p=0.006，HR：0.30，95%CI：0.17-0.83）均有优势。在 3 个或更多阳性腮腺淋巴结的患者中，与 ENI 相比，END 可显著提高 RC（p<0.001）和 OS（p=0.001）。在华盛顿大学生活质量问卷的 12 个领域，两组患者均无差异。
在 P+ HNcSCC 的颈部管理中，不建议观察。END 是首选方法，但除了 3 个或更多转移性腮腺淋巴结外，ENI 是一种替代方法，在生存或 QoL 方面没有妥协。
