Department of Traumatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Plast Reconstr Aesthet Surg. 2024 Dec;99:584-591. doi: 10.1016/j.bjps.2024.10.002. Epub 2024 Oct 11.
Dementia, characterized by memory loss and cognitive impairment, considerably impacts individuals and society. Our research focused on cervical lymph nodes, crucial for CNS lymphatic drainage, in the context of dementia. We hypothesized that the patients with head and neck cancer (HNC) undergoing cervical lymph node dissection (CLND) may have increased dementia risk due to obstructed lymphatic pathways.
We conducted a retrospective analysis of the electronic medical records from patients over 60 years diagnosed with HNC who underwent CLND between March 2007 and April 2023. We collected demographic data, calculated dementia incidence rates, and compared parameters between patients with and without dementia.
Among the 251 patients with HNC who underwent CLND, 234 were men and 17 were women. Nine male patients developed dementia within an average of 50.1 ± 35.3 months post-surgery. The dementia incidence rate was 0.7 per 100 patient-years, with a cumulative incidence of 10.34% over 8.6 years. The CLND patterns were associated with dementia (p = 0.028), with bilateral supraomohyoid neck dissection (SOHND)/modified radical neck dissection (MRND) and unilateral MRND combined with any neck dissection type on the other side presenting higher risks than unilateral MRND/SOHND (p = 0.016).
Patients with HNC undergoing bilateral and comprehensive lymph node dissection showed higher dementia risk, highlighting the importance of the neck's lymphatic role in brain health. These findings may guide future surgical practices.
痴呆症以记忆力减退和认知障碍为特征，严重影响个人和社会。我们的研究集中在颈部淋巴结上，这些淋巴结对于中枢神经系统的淋巴引流至关重要，特别是在痴呆症的背景下。我们假设接受颈部淋巴结清扫术（CLND）的头颈部癌症（HNC）患者由于淋巴通路受阻，可能会增加痴呆症的风险。
我们对 2007 年 3 月至 2023 年 4 月期间接受 CLND 的 60 岁以上诊断为 HNC 的患者的电子病历进行了回顾性分析。我们收集了人口统计学数据，计算了痴呆症的发病率，并比较了痴呆症患者和非痴呆症患者之间的参数。
在接受 CLND 的 251 例 HNC 患者中，男性 234 例，女性 17 例。9 例男性患者在手术后平均 50.1 ± 35.3 个月后出现痴呆症。痴呆症的发病率为 0.7 例/100 患者年，8.6 年内累积发病率为 10.34%。CLND 模式与痴呆症相关（p = 0.028），双侧上颈区清扫术（SOHND）/改良根治性颈清扫术（MRND）和单侧 MRND 联合另一侧任何颈清扫术的风险高于单侧 MRND/SOHND（p = 0.016）。
接受双侧和全面淋巴结清扫术的 HNC 患者痴呆症风险较高，这突出了颈部淋巴结在大脑健康中的重要作用。这些发现可能为未来的手术实践提供指导。
