Marshall K A, Edgerton M T
Am J Surg. 1977 Feb;133(2):216-7. doi: 10.1016/0002-9610(77)90083-6.
In the past, neck dissections have been recommended only when nodes were clinically palpable or when they became so. A retrospective ten year study of thirty-seven patients with carcinoma of the lip and with an unusually high mortality has allowed reevaluation of indications for neck dissection. (1) Ten of thirty-seven patients died of this disease and nearly all of the ten died with and because of regional metastases. (2) Seven patients with nonpalpable nodes initally had nodal metastases later which, despite neck dissection at that later time, proved lethal. (3) Two patients who, despite nonpalpable nodes, had undergone neck dissections and were found to have occult bilateral nodal metastases were effectively cured with early neck dissection. This suggests that early bilateral supramohyoid neck dissections for small carcinomas of the lip and ipsilateral radical neck dissections for large primaries may yield higher cure rates than currently achieved.
过去，仅当临床上可触及淋巴结或淋巴结变得可触及 时，才建议进行颈部清扫术。一项对37例唇癌患者进行的为期十年的回顾性研究，这些患者的死亡率异常高，这使得对颈部清扫术的适应症进行了重新评估。（1）37例患者中有10例死于该病，这10例中几乎所有人都因区域转移而死亡。（2）7例最初淋巴结不可触及的患者后来发生了淋巴结转移，尽管在后来进行了颈部清扫术，但仍被证明是致命的。（3）2例尽管淋巴结不可触及，但已接受颈部清扫术，发现有隐匿性双侧淋巴结转移的患者，通过早期颈部清扫术得到了有效治愈。这表明，对于小的唇癌进行早期双侧舌骨上颈部清扫术，对于大的原发肿瘤进行同侧根治性颈部清扫术，可能会比目前的治愈率更高。
