Razack M S, Silapasvang S, Sako K, Shedd D P
Am J Surg. 1978 Oct;136(4):520-4. doi: 10.1016/0002-9610(78)90274-x.
One hundred twelve patients treated by surgery alone for squamous cell carcinoma of the epiglottis were retrospectively reviewed. The results showed: (1) 27 per cent of patients with N0 disease had microscopic nodal metastases; (2) 35 to 47 per cent of patients with N0 and N1 disease and histologically positive nodes (micrometastases) in the initial neck dissection developed contralateral nodal metastases; (3) 36.9 per cent of the patients who had nodal micrometastases (histologically positive) survived five years, as contrasted with 94.5 per cent of those who did not have node involvement; (4) 53.2 per cent of the patients who had nodal metastases in one neck and 16 per cent of those who had metastases in both necks survived five years; (5) when the primary tumor in the epiglottis was located in the midline or there was bilateral supraglottic involvement, 18 to 50 per cent of patients developed contralateral ("second") neck nodal metastases; (6) performing early elective contralateral ("second") neck dissection shortly after recovery from the initial surgery may improve survival of patients in whom either the "first" neck dissection showed microscopic nodal metastases and/or the primary tumor was located either in midline or there was bilateral supraglottic involvement.
对112例仅接受手术治疗的会厌鳞状细胞癌患者进行了回顾性研究。结果显示：（1）N0期患者中有27%存在微小淋巴结转移；（2）N0和N1期且初次颈部清扫组织学检查发现阳性淋巴结（微转移）的患者中，35%至47%出现了对侧淋巴结转移；（3）有淋巴结微转移（组织学检查阳性）的患者中，36.9%存活了5年，而无淋巴结受累的患者这一比例为94.5%；（4）一侧颈部有淋巴结转移的患者中，53.2%存活了5年，双侧颈部有转移的患者中这一比例为16%；（5）当会厌原发性肿瘤位于中线或双侧声门上受累时，18%至50%的患者出现对侧（“第二”）颈部淋巴结转移；（6）在初次手术后恢复不久即进行早期选择性对侧（“第二”）颈部清扫，可能会提高“第一”次颈部清扫显示有微小淋巴结转移和/或原发性肿瘤位于中线或双侧声门上受累患者的生存率。
