分区性颈清扫术应用在cN0和cN1期口腔癌中的远期效果  

Long-Term Results of Selective Neck Dissection for Oral Cavity Carcinoma with cN0 and cN1 Neck Disease

作　　者：樊大庆[1] 胡少南[1] 

机构地区：[1]湖北省肿瘤医院头颈外科,湖北武汉430079

出　　处：《肿瘤基础与临床》2006年第3期233-234,共2页journal of basic and clinical oncology

摘　　要：目的头颈部鳞状细胞癌的颈淋巴结的处理与预后密切相关,本文探讨了分区性颈清扫术应用于早期口腔鳞状细胞癌颈部转移的远期效果。方法84例cN0或cN1期患者均接受了术前化疗,分区性颈清扫术及术后放疗,并复习文献对比多种术式的颈部复发率。结果84例中1例死于肿瘤复发转移,53例cN1中有10例为pN0,全组颈部复发率为13.2%。cN0中有6例出现隐性转移,该组复发率为6.5%。按是否侵犯包膜外颈部复发率分别是20.0%和10.3%。结论分区性颈清扫术在cN0和cN1期口腔鳞状细胞癌的治疗上可以取代改良性颈清扫和全颈清扫术。Objective The management of cervical lymph node metastases in squamous head and neck cancers was important independent prognosticator of outcome, we discussed the long-term results of selective neck dissection for early oral cavity carcinoma. Methods All the 84 patients underwent preoperative chemotherapy, selective neck dissection and postoperative radiation therapy for clinical cN0 and cN1 neck disease, and we reviewed comprehensively the literatures reporting and comparing with recurrence rates for both neck dissection types. Results One patient died from tumor metastases. 53 patients with clinical cN1, of these, 10 was confirmed histologically as pN0, the overall neck recurrence rate was 13.2 %. in the group of clinical cN0, the neck recurrence rate was 6.5%, of these, 6 patients had microscopic disease. According to node extracapsular spread, the neck recurrence rates were 20.0% and 10.3 %. Conclusions We had adequate data to indicate that the selective neck dissection could replace the modified radical neck dissections as the best surgical procedure for oral cavity carcinoma with clinical cN0 and cN1 neck disease.

关 键 词：口腔肿瘤 鳞状细胞癌 淋巴转移 颈淋巴结清扫术 复发率 

分 类 号：R739.85[医药卫生—肿瘤] R730.56[医药卫生—临床医学]