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颈部淋巴结转移的管理

Management of metastases to the lymph glands of the neck.

作者信息

Stell P M, Green J R

出版信息

Proc R Soc Med. 1976 Jun;69(6):411-13. doi: 10.1177/003591577606900609.

DOI:10.1177/003591577606900609
PMID:959210
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1864298/
Abstract

The survival rate of matched pairs of patients, one patient in each pair being submitted to prophylactic neck dissection, the other to a policy of "wait and see" has been measured: there was no significant difference in the survival rates of the two groups. Surgery for most patients with a gland in the neck gives better results than radiotherapy, and can produce satisfactory results with such procedures as supraglottic laryngectomy to epiglottic tumours and replacement with the deltopectoral flap for tonsillar tumours. On the other hand, surgery is probably contraindicated for patients with antral carcinoma and a gland in the neck, whom it rarely cures. Surgery does not increase the survival of patients with bilateral glands in the neck (except those with supraglottic tumours) and its contraindicated. Surgery can prolong the survival of patients with nodes fixed to the skin, the mandible or the external carotid artery, and may occassionally cure such patients.

摘要

已对配对患者的生存率进行了测定,每对患者中,一名接受预防性颈部清扫术,另一名采取“观察等待”策略:两组的生存率无显著差异。对于大多数颈部有淋巴结的患者,手术治疗的效果优于放射治疗,并且对于会厌肿瘤行声门上喉切除术以及对于扁桃体肿瘤采用胸大肌三角肌皮瓣修复等手术能产生满意的效果。另一方面,对于患有鼻窦癌且颈部有淋巴结的患者,手术可能是禁忌的,因为手术很少能治愈这类患者。手术并不能提高双侧颈部有淋巴结患者(声门上肿瘤患者除外)的生存率,且手术是禁忌的。手术可延长淋巴结与皮肤、下颌骨或颈外动脉粘连患者的生存期,并且偶尔可治愈这类患者。

相似文献

1
Management of metastases to the lymph glands of the neck.颈部淋巴结转移的管理
Proc R Soc Med. 1976 Jun;69(6):411-13. doi: 10.1177/003591577606900609.
2
The management of cervical lymph nodes in head and neck cencer.头颈部癌症中颈部淋巴结的管理
Proc R Soc Med. 1975 Feb;68(2):83-5. doi: 10.1177/003591577506800207.
3
[Cervical lymph node metastasis and recurrence in supraglottic carcinoma after operation].声门上型癌术后颈部淋巴结转移及复发情况
Zhonghua Er Bi Yan Hou Ke Za Zhi. 1999 Apr;34(2):108-10.
4
The treatment of squamous cell carcinoma of the tonsil with neck node metastases.伴有颈部淋巴结转移的扁桃体鳞状细胞癌的治疗
Head Neck. 2003 Jan;25(1):24-31. doi: 10.1002/hed.10183.
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Peroperative diagnosis and treatment of metastases to the regional lymph nodes in papillary carcinoma of the thyroid gland.甲状腺乳头状癌区域淋巴结转移的术中诊断与治疗
Surg Gynecol Obstet. 1989 Aug;169(2):107-14.
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[Supraglottic laryngectomy with or without one arytenoid in epiglottic carcinoma. A report of 40 cases].[会厌癌行声门上喉切除术伴或不伴一侧杓状软骨切除。40例报告]
Zhonghua Zhong Liu Za Zhi. 1998 May;20(3):231-2.
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[Lateral neck dissection vs radical neck dissection in the management of supraglottic carcinoma with pathologically negative nodes].[声门上型癌伴病理阴性淋巴结患者治疗中侧颈清扫术与根治性颈清扫术的比较]
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2003 Dec;38(6):426-9.
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Neck management in patients undergoing postradiotherapy salvage laryngeal surgery for recurrent/persistent laryngeal cancer.接受复发性/持续性喉癌放疗后挽救性喉手术患者的颈部处理
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[The N0 neck in patients treated by supraglottic laryngectomy: abstention, surgery or radiotherapy?].[声门上喉切除术治疗患者的N0颈部:观察等待、手术还是放疗?]
Rev Laryngol Otol Rhinol (Bord). 1997;118(3):173-7.
10
Treatment of contralateral N0 neck in early squamous cell carcinoma of the oral tongue: elective neck dissection versus observation.早期舌癌对侧N0颈部的治疗:选择性颈部清扫术与观察对比
Laryngoscope. 2006 Mar;116(3):461-5. doi: 10.1097/01.mlg.0000195366.91395.9b.

引用本文的文献

1
The "gregorio marañon" hospital experience in the treatment of laryngeal carcinoma.“格雷戈里奥·马拉尼翁”医院治疗喉癌的经验
Indian J Otolaryngol Head Neck Surg. 1997 Jul;49(3):228-46. doi: 10.1007/BF02991284.
2
Management of metastatic cervical lymph nodes.转移性颈部淋巴结的管理
Proc R Soc Med. 1976 Nov;69(11):865-7. doi: 10.1177/003591577606901155.
3
The role of histopathology in diagnosis and prognosis of oral squamous cell carcinoma.
Proc R Soc Med. 1976 Oct;69(10):740-7. doi: 10.1177/003591577606901006.

本文引用的文献

1
Cancer of the pharynx. A study based on 2,417 cases with special reference to radiation treatment.
J Laryngol Otol. 1967 Feb;81(2):151-72.
2
Experience with the medially based deltopectoral flap in reconstructuve surgery of the head and neck.
Br J Plast Surg. 1971 Apr;24(2):174-83. doi: 10.1016/s0007-1226(71)80037-1.
3
Penetration of the cervical lymph node system by cancer.癌症对颈部淋巴结系统的侵犯
Proc R Soc Med. 1976 Jun;69(6):409-11. doi: 10.1177/003591577606900608.