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针对源自非头颈部区域的转移性淋巴结进行颈部清扫术的临床意义。

Clinical implication of neck dissection for metastatic lymph nodes originating from non-head and neck regions.

作者信息

Kim Min Ji, Kang So Hee, Kwon MinSu, Jung Young Ho, Choi Seung-Ho, Nam Soon Yuhl, Lee Yoon Se

机构信息

Department of Otolaryngology-Head & Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea.

出版信息

Acta Otolaryngol. 2024 Feb;144(2):153-157. doi: 10.1080/00016489.2024.2327406. Epub 2024 Mar 16.

Abstract

BACKGROUND

Cervical lymph node metastasis (CLNM) from remote primary sites is rare in head and neck cancer. The efficacy of neck dissection is still being investigated for therapeutic benefits of local management in oligometastasis from non-head and neck cancer.

OBJECTIVES

To evaluate the clinical efficacy of neck dissection (ND) in CLNM from distant primary cancers and identify factors contributing to improved survival.

MATERIALS AND METHODS

This retrospective case-control study enrolled patients who underwent ND for CLNM from distant primary cancer at Asan Medical Centre between January 2010 and December 2020. We analysed overall survival and association between clinical covariate and survival.

RESULTS

The study included 31 (14 males, 17 females) among 114 patients. Ovarian cancer was the most common primary malignancy (32.3%). Patients with fewer than three metastatic lymph nodes, without extranodal extension and with adjuvant therapy after surgery had better survival rates.

CONCLUSION AND SIGNIFICANCE

In patients with CLNM from a distant primary cancer, ND is beneficial as local treatment. And adequate selection of patients for ND is pivotal to improve prognosis.

摘要

背景

头颈部癌中,远处原发部位的颈部淋巴结转移(CLNM)较为罕见。对于非头颈部癌寡转移的局部治疗,颈部清扫术的疗效仍在研究中。

目的

评估颈部清扫术(ND)治疗远处原发癌所致CLNM的临床疗效,并确定有助于提高生存率的因素。

材料与方法

这项回顾性病例对照研究纳入了2010年1月至2020年12月在峨山医学中心因远处原发癌所致CLNM接受ND治疗的患者。我们分析了总生存率以及临床协变量与生存率之间的关联。

结果

114例患者中有31例(14例男性,17例女性)纳入研究。卵巢癌是最常见的原发恶性肿瘤(32.3%)。转移淋巴结少于3个、无结外扩展且术后接受辅助治疗的患者生存率更高。

结论与意义

对于远处原发癌所致CLNM患者,ND作为局部治疗有益。合理选择接受ND治疗的患者对于改善预后至关重要。

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