Significance of extracapsular lymph node metastases in patients with head and neck squamous cell carcinoma.
Significance of extracapsular lymph node metastases in patients with head and neck squamous cell carcinoma.
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DOI：
10.1097/00020840-200304000-00010
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发表时间：
2003-04-01
影响因子：
1.6
通讯作者：
Hanna, Ehab
中科院分区：
文献类型：
--
作者：
Puri, Sajeev K;Fan, Chun-Yang;Hanna, Ehab
颈淋巴转移的存在仍然是头颈部鳞状细胞癌患者生存和疾病复发的最重要的预后指标。在头颈部鳞状细胞癌患者中，随着淋巴结转移的发展，5年生存率大约下降了50%。当有淋巴转移的包膜外扩散时，存活率进一步急剧和显着下降，局部区域和远处失败率高得令人无法接受。包膜外扩散可见于大部分大于3厘米的淋巴结节和大量小于2厘米的淋巴结。包膜外扩散甚至出现在直径小于1厘米的淋巴结中。因此，包膜外扩散是生存、局部区域复发和远处转移的最重要的预测指标。淋巴包膜以外的转移疾病的扩散需要针对局部疾病的积极治疗，并应对远处转移的高发生率。
The presence of cervical lymph node metastasis remains the most significant prognostic indicator of survival and disease recurrence in patients with squamous cell carcinoma of the head and neck. An approximately 50% reduction in 5-year survival rate is seen with the development of lymph node metastasis in patients with squamous cell carcinoma of the head and neck. A further precipitous and significant decline in survival and an unacceptably high rate of local-regional and distant failure occurs when extracapsular spread of lymph node metastasis is present. Extracapsular spread is noted in a majority of the lymph nodes larger than 3 cm and in a significant number of nodes less than 2 cm. Extracapsular spread has even been demonstrated in lymph nodes measuring less than 1 cm. Extracapsular spread, thus, is the most important predictor of survival, local-regional recurrence, and distant metastasis. The spread of metastatic disease beyond the lymph node capsule demands aggressive therapy directed toward local-regional disease and addressing the high incidence of distant metastases.