Pastore A, Merlo R, Chiarello G, Calearo C
Clinica Otorinolaringoiatrica, Università di Ferrara.
Acta Otorhinolaryngol Ital. 1995 Apr;15(2):87-90.
Cervical lymph-node treatment in parotid gland epithelial malignancies is still debated. According to Literature, three different strategies (surgery, radiotherapy, "wait and see") have all been proposed theoretically, particularly when dealing with N0 cases. The present study was designed to evaluate the results of different lymphonode treatment strategies in 57 parotid gland carcinomas followed at the ENT Clinic of the University of Ferrara. The most frequent hystological patterns appeared to be the adenoidcystic carcinoma (33.3%) and the mucoepidermoid tumor (21.1%). Total parotidectomy was the treatment of choice in all cases. Ipsilateral neck dissection was performed in 14 cases (24.5%), 5 cases being N0. In 27 patients (47.4%) postsurgical radiotherapy was applied: in 7 cases on T and in 20 on both T and N.T recurrences were 7, while those of N and of both T and N were respectively 2 and 2. No occult metastases were found in N0 dissected patients. The results obtained led the Authors to the following conclusions: -neck dissection is fundamental in treatment of clinical adenopathies in any parotid gland malignancy: -postsurgical radiotherapy on the neck is the treatment of choice in all N0 carcinomas except in cases of acinic cell and mucoepidermoid carcinomas, where a "wait and see" policy seems to be more suitable.
腮腺上皮性恶性肿瘤的颈部淋巴结治疗仍存在争议。根据文献，理论上已提出三种不同的策略（手术、放疗、“观察等待”），尤其是在处理N0病例时。本研究旨在评估费拉拉大学耳鼻喉科诊所随访的57例腮腺癌患者采用不同淋巴结治疗策略的结果。最常见的组织学类型似乎是腺样囊性癌（33.3%）和黏液表皮样瘤（21.1%）。所有病例均选择全腮腺切除术。14例（24.5%）患者进行了同侧颈部清扫术，其中5例为N0。27例（47.4%）患者术后接受了放疗：7例仅对T区放疗，20例对T区和N区均放疗。T区复发7例，N区及T区和N区均复发的分别为2例和2例。在接受颈部清扫术的N0患者中未发现隐匿性转移。所得结果使作者得出以下结论：——颈部清扫术对于任何腮腺恶性肿瘤的临床淋巴结病变治疗至关重要；——除腺泡细胞癌和黏液表皮样癌外，颈部术后放疗是所有N0癌的首选治疗方法，对于这两种癌症，“观察等待”策略似乎更合适。
