新辅助化疗后头颈部鳞状细胞癌的临床病理回顾。
Clinicopathological Review of Head and Neck Squamous Cell Carcinomas After Neoadjuvant Chemotherapy.
机构信息
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Anticancer Res. 2024 Oct;44(10):4593-4603. doi: 10.21873/anticanres.17289.
BACKGROUND/AIM: The benefit of neoadjuvant chemotherapy (NAC) in the treatment of head and neck squamous cell carcinoma (HNSCC) remains unclear.
PATIENTS AND METHODS
We retrospectively collected 30 patients with HNSCC who had undergone radical resection after NAC. We pathologically evaluated the therapeutic response to NAC, and classified the residual tumor patterns. In addition, we compared the maximum horizontal diameter on pathology with imaging.
RESULTS
The residual patterns were categorized as follows: 10 cases of shrunken type, 11 cases of mixed type, and seven cases of fragmented type. The majority of underestimation cases - those cases in which the maximum horizontal diameter measured on post-NAC imaging was less than the pathological size after resection - were multifocal residual lesions, with a tendency for more frequent "positive" or "close" surgical margins.
CONCLUSION
The strategy of performing NAC to reduce resection volume is not appropriate, and resection margins should be based on the assessment before NAC.
背景/目的：新辅助化疗（NAC）在头颈部鳞状细胞癌（HNSCC）治疗中的获益仍不明确。
患者与方法
我们回顾性收集了 30 例接受 NAC 后行根治性切除术的 HNSCC 患者。我们对 NAC 的治疗反应进行了病理评估，并对残留肿瘤模式进行了分类。此外，我们比较了影像学上的最大水平直径与病理上的最大水平直径。
结果
残留模式分为：缩小型 10 例，混合型 11 例，碎裂型 7 例。大多数低估病例（NAC 后影像学测量的最大水平直径小于切除后病理大小的病例）为多灶性残留病变，且“阳性”或“临近”切缘的发生率更高。
结论
通过 NAC 来缩小切除范围的策略并不合适，应该根据 NAC 前的评估来确定切缘。
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