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.
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.
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。
Zotero 插件