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影响颈部清扫术淋巴结检出数和密度的因素。

Factors affecting lymph node yield and density in neck dissection.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.

Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

Acta Otolaryngol. 2024 May-Jun;144(5-6):379-383. doi: 10.1080/00016489.2024.2380863. Epub 2024 Jul 23.

Abstract

BACKGROUND

Studies suggest that neck dissections with a minimum of 16-18 yielded nodes are associated with better overall survival compared to neck dissections with lower yields.

AIMS

We aimed to identify factors affecting the lymph node yield and density in patients with oral cavity cancer undergoing elective neck dissection levels 1-3.

MATERIALS AND METHODS

Using prospectively registered data, we conducted a population-based cohort study on all patients surgically treated for oral cavity cancer including levels 1-3 neck dissection at our institution from 2018 to 2022. Uni and multivariate analyses were performed to identify factors associated with lymph node yields.

RESULTS

In total, 221 patients were included. The mean lymph nodes yield and density were 19 (95%CI 18-20) and 0.12 (95%CI 0.09-0.16), respectively. In multivariate analysis, increasing body weight ( = .034) was positively and previous radiotherapy ( = .006) were negatively correlated with the number of yielded lymph nodes. Lymph node density was positively correlated with body weight ( = .011) and body mass index ( = .032) in univariate analysis.

CONCLUSIONS AND SIGNIFICANCE

Increasing body weight was positively and previous radiotherapy was negatively correlated to lymph node yield. These factors should be taken into consideration when interpreting the lymph node yield as an indicator of neck dissection quality.

摘要

背景

研究表明,与淋巴结检出量较低的颈部清扫术相比,检出量至少为 16-18 枚的颈部清扫术与更好的总生存率相关。

目的

我们旨在确定影响行择期 1-3 区颈清扫术的口腔癌患者淋巴结检出量和密度的因素。

材料和方法

使用前瞻性注册数据,我们对 2018 年至 2022 年在我们机构接受包括 1-3 区颈清扫术的口腔癌手术治疗的所有患者进行了一项基于人群的队列研究。进行了单因素和多因素分析,以确定与淋巴结检出量相关的因素。

结果

共纳入 221 例患者。平均淋巴结检出量和密度分别为 19(95%CI 18-20)和 0.12(95%CI 0.09-0.16)。多因素分析显示,体重增加( = .034)与淋巴结检出量呈正相关,而既往放疗( = .006)与淋巴结检出量呈负相关。淋巴结密度与体重( = .011)和体重指数( = .032)在单因素分析中呈正相关。

结论和意义

体重增加与淋巴结检出量呈正相关,而既往放疗与淋巴结检出量呈负相关。在解释淋巴结检出量作为颈部清扫术质量的指标时,应考虑这些因素。

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