Spriano G, Roselli R
Divisione di Otorinolaringoiatria, Ospedale di Circolo e Fondazione Macchi, Varese.
Acta Otorhinolaryngol Ital. 1995 Jun;15(3):159-62; discussion 163.
Skin carcinomas of the head and neck can produce lymphatic metastases: the main lymphatic station of drainage is in the lymph nodes of the parotid region, especially for tumours of the upper 2/3 of the face. The analysis of the prognostic factors (site of origin, etiology, immunodepression, previous treatment, size, thickness, grading, perineural invasion, rapid growth) identifies a group of patient at risk, for local recurrence and for lymphatic metastases. In those cases, representing less than 10% of these tumours, the prophylactic treatment of lymph nodes-parotid and neck nodes-can be reasonable. The cases N positive have a severe prognosis, in these patients an aggressive surgical treatment, extended to both parotid and neck nodes, followed by radiotherapy, is justified. Only prospective studies and statistical evaluation of results, could define the real prognostic importance of different factors and the best treatment for the lymph nodes.
主要引流淋巴结位于腮腺区，尤其是面部上2/3的肿瘤。对预后因素（起源部位、病因、免疫抑制、既往治疗、大小、厚度、分级、神经周围浸润、生长速度）的分析可确定一组有局部复发和淋巴转移风险的患者。在这些占此类肿瘤不到10%的病例中，对腮腺和颈部淋巴结进行预防性治疗可能是合理的。N阳性病例预后较差，在这些患者中，积极的手术治疗，包括双侧腮腺和颈部淋巴结清扫，随后进行放疗是合理的。只有前瞻性研究和结果的统计评估，才能确定不同因素的真正预后重要性以及淋巴结的最佳治疗方法。
