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覆膜支架植入联合根治性肿瘤切除术治疗累及颈动脉的晚期头颈部鳞状细胞癌:与历史文献的对比研究。

Application of covered stent implantation combined with radical tumor resection in advanced head and neck squamous cell carcinoma involving the carotid artery: a comparative study with historical literature.

机构信息

Clinical Medicine Department, School of Medicine, Southeast University, Nanjing, Jiangsu, China.

Department of Otolaryngology Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Acta Otolaryngol. 2024 Sep;144(9):524-530. doi: 10.1080/00016489.2024.2400299. Epub 2024 Sep 20.

Abstract

BACKGROUND

Studies have shown that carotid artery reconstruction results in the best overall survival (OS) in Advanced Head and Neck Squamous Cell Carcinoma involving the Carotid Artery (AHNSCC-CA).

AIMS

The purpose of this study was to evaluate the efficacy of covered stent implantation combined with radical tumor resection and to compare and analyze the historical literature on conventional carotid artery resection and reconstruction.

MATERIALS AND METHODS

A total of 68 patients with AHNSCC-CA were included in this study. This study compared the survival, local recurrence, surgical complications, and neurologic complications between the two groups.

RESULTS

The OS rate at 12 months in the experimental group was 58.5% (median survival time: 15 months, 95% CI: 7.61-22.40). The OS rate at 12 months in the control group was 34.3% (median survival time: 8 months, 95% CI: 3.94-12.06,  = .371). In addition, the differences in the rates of local recurrence, surgical complications and neurological complications between the two groups were statistically insignificant ( = .677,  = .197 and  = .617).

CONCLUSIONS AND SIGNIFICANCE

Compared with conventional carotid artery resection and reconstruction, covered stent implantation combined with radical tumor resection yields similar survival outcomes, but with significantly lower surgical risk and difficulty, and faster postoperative recovery.

摘要

背景

研究表明,在涉及颈动脉的晚期头颈部鳞状细胞癌(AHNSCC-CA)中,颈动脉重建可获得最佳的总生存(OS)。

目的

本研究旨在评估覆膜支架植入联合根治性肿瘤切除术的疗效,并对常规颈动脉切除和重建的历史文献进行比较和分析。

材料和方法

本研究共纳入 68 例 AHNSCC-CA 患者。比较两组患者的生存、局部复发、手术并发症和神经并发症。

结果

实验组 12 个月 OS 率为 58.5%(中位生存时间:15 个月,95%CI:7.61-22.40)。对照组 12 个月 OS 率为 34.3%(中位生存时间:8 个月,95%CI:3.94-12.06, = .371)。此外,两组患者局部复发率、手术并发症发生率和神经并发症发生率差异无统计学意义( = .677,  = .197 和  = .617)。

结论和意义

与常规颈动脉切除和重建相比,覆膜支架植入联合根治性肿瘤切除术具有相似的生存结果,但手术风险和难度显著降低,术后恢复更快。

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