Steinhart H, Schroeder H G, Buchta B, Schmidt A, Kleinsasser O
Universitäts-Hals-Nasen-Ohren-Klinik Marburg/Lahn.
Laryngorhinootologie. 1994 Dec;73(12):620-5. doi: 10.1055/s-2007-997209.
In a retrospective study we evaluated the clinical and histological datas of patients with squamous cell carcinomas of the head and neck to determine the influence of extranodal spread in metastases for the prognosis. Lymph nodes were dissected from the neck dissection specimens and investigated histologically with special regard to extranodal spread. 304 patients (58%) showed positive lymph nodes and 212 of this patients had additionally extranodal spread (70%). Hence, the rate of extranodal spread in the whole investigated group (522 patients) was 40%. For the patients with carcinomas of the hypopharynx the rate of extranodal spread was especially high (70%). Most extranodal spread could be found at levels 2, 3 and 4. We found a correlation between the appearance of extranodal spread and increasing T-stage. 5-year survival rates were greatly different for patients with no metastases (77%) and patients with extranodal spread (28%). We discuss the use of the criteria extranodal spread for the planning of adjuvant chemotherapy.
在一项回顾性研究中，我们评估了头颈部鳞状细胞癌患者的临床和组织学数据，以确定结外扩散对转移预后的影响。从颈部清扫标本中取出淋巴结，并对其进行组织学检查，特别关注结外扩散情况。304例患者（58%）出现阳性淋巴结，其中212例患者还存在结外扩散（70%）。因此，在整个研究组（522例患者）中，结外扩散率为40%。下咽癌患者的结外扩散率尤其高（70%）。大多数结外扩散见于2、3和4区。我们发现结外扩散的出现与T分期增加之间存在相关性。无转移患者（77%）和有结外扩散患者（28%）的5年生存率差异很大。我们讨论了结外扩散标准在辅助化疗计划中的应用。
