Lydiatt D D, Robbins K T, Byers R M, Wolf P F
Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston.
Head Neck. 1993 Jul-Aug;15(4):308-12. doi: 10.1002/hed.2880150407.
We reviewed 156 previously untreated patients with squamous cell carcinoma of the oral tongue staged T1 and T2 to determine the incidence of nodal metastasis, and if elective neck dissection affected local/regional control or survival. Patients were divided into two nonrandomized groups: group 1, intraoral glossectomy only (102 patients); and group 2, intraoral glossectomy plus neck dissection (54 patients). Analysis revealed no significant differences for tumor location, histologic differentiation, status of margins, or clinical appearance; however, perineural invasion significantly adversely affected survival and local/regional control. In group 1 patients, 16.5% subsequently developed cervical metastasis, and 20.4% of patients in group 2 had occult nodal disease. The survival and local/regional control for group 1 patients subsequently developing nodes was 33% and 50%, respectively. The survival and local/regional control for group 2 patients with occult metastasis was 55% and 91%, respectively. We believe elective neck dissection is indicated for early staged oral tongue cancer.
我们回顾了156例先前未经治疗的口腔舌鳞状细胞癌T1和T2期患者，以确定区域淋巴结转移的发生率，以及选择性颈清扫术是否影响局部/区域控制或生存率。患者被分为两个非随机组：第1组，仅行口腔内舌切除术（102例患者）；第2组，口腔内舌切除术加颈清扫术（54例患者）。分析显示，在肿瘤位置、组织学分化、切缘状态或临床表现方面无显著差异；然而，神经侵犯对生存率和局部/区域控制有显著不利影响。在第1组患者中，16.5%随后发生颈部转移，第2组患者中有20.4%存在隐匿性淋巴结疾病。第1组随后发生淋巴结转移的患者的生存率和局部/区域控制率分别为33%和50%。第2组有隐匿性转移的患者的生存率和局部/区域控制率分别为55%和91%。我们认为早期口腔舌癌患者应行选择性颈清扫术。
