头颈部癌原发部位的复发以及颈部淋巴结转移作为预后因素的意义。
Recurrence at the primary site in head and neck cancer and the significance of neck lymph node metastases as a prognostic factor.
作者信息
Leemans C R, Tiwari R, Nauta J J, van der Waal I, Snow G B
机构信息
Department of Otolaryngology-Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.
出版信息
Cancer. 1994 Jan 1;73(1):187-90. doi: 10.1002/1097-0142(19940101)73:1<187::aid-cncr2820730132>3.0.co;2-j.
BACKGROUND
Biologic aggressiveness of head and neck carcinoma is reflected in its capability to metastasize to regional lymph nodes and its propensity to recur after treatment.
METHODS
The authors report on 244 patients treated at the Department of Otolaryngology-Head and Neck Surgery of the Free University Hospital, Amsterdam, The Netherlands, with excision of primary tumor with incontinuity neck dissection with or without postoperative radiation therapy between January 1973 and July 1986. All patients had surgical margins free of tumor.
RESULTS
The overall recurrence rate was 12.3%. Stages T3-4 and the presence of more than three positive nodes on histopathologic examination were associated with a 16.2% and 26.2% incidence in recurrence at the primary site, respectively. No prognostic influence arose from primary tumor localization, three or fewer positive nodes, extranodal spread, and postoperative radiation therapy.
CONCLUSIONS
Patients with T3-4 disease and those with more than three positive lymph nodes may benefit from novel adjuvant treatment modalities.
背景
头颈癌的生物学侵袭性体现在其转移至区域淋巴结的能力以及治疗后复发的倾向。
方法
作者报告了1973年1月至1986年7月期间在荷兰阿姆斯特丹自由大学医院耳鼻咽喉 - 头颈外科接受治疗的244例患者，这些患者接受了原发肿瘤切除并进行了连续性或非连续性颈部清扫，术后接受或未接受放射治疗。所有患者的手术切缘均无肿瘤。
结果
总复发率为12.3%。T3 - 4期以及组织病理学检查发现三个以上阳性淋巴结的患者，原发部位复发率分别为16.2%和26.2%。原发肿瘤定位、三个或更少阳性淋巴结、结外扩散以及术后放射治疗对预后均无影响。
结论
患有T3 - 4期疾病以及有三个以上阳性淋巴结的患者可能会从新的辅助治疗方式中获益。
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