Yuen A P, Wei W I, Wong S H
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Arch Otolaryngol Head Neck Surg. 1996 Jul;122(7):742-5. doi: 10.1001/archotol.1996.01890190038010.
To analyze the problem of nodal recurrence of N0 neck advanced laryngeal carcinoma.
Retrospective analysis.
Hospital referral center.
One hundred thirty-three patients with cancer stages T3-T4, N0, M0 who had total laryngectomy between January 1981 and December 1990.
Nodal recurrence.
Of the 11 patients who had elective radical neck dissections, there was no nodal recurrence. Of the other 122 patients who had no elective neck dissection, 19 patients (16%) developed nodal recurrence and all nodal recurrence was at levels II, III, and IV. Twelve patients (63%) underwent salvage radical neck dissection for nodal recurrence and they had a 38% adjusted 5-year actuarial survival rate. Of these 122 patients who had no elective neck dissection for the N0 neck, 12 patients (10%) eventually died of nodal recurrence.
The watchful waiting policy is a satisfactory management option of N0 neck of advanced laryngeal carcinoma.
分析N0颈部晚期喉癌的淋巴结复发问题。
回顾性分析。
医院转诊中心。
1981年1月至1990年12月期间接受全喉切除术的133例癌症分期为T3 - T4、N0、M0的患者。
淋巴结复发。
在11例行择期根治性颈清扫术的患者中，无淋巴结复发。在另外122例未行择期颈清扫术的患者中，19例（16%）出现淋巴结复发，且所有淋巴结复发均发生在Ⅱ、Ⅲ和Ⅳ区。12例（63%）患者因淋巴结复发接受挽救性根治性颈清扫术，其调整后的5年精算生存率为38%。在这122例未对N0颈部行择期颈清扫术的患者中，12例（10%）最终死于淋巴结复发。
观察等待策略是晚期喉癌N0颈部的一种令人满意的处理选择。
