Outcomes in squamous cell carcinoma with advanced neck disease
Outcomes in squamous cell carcinoma with advanced neck disease
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DOI：
10.1308/003588407x205314
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发表时间：
2007-10-01
影响因子：
1.4
通讯作者：
Cox, Graham J.
中科院分区：
文献类型：
--
作者：
Keir, James A.;Whiteside, Olivia J. H.;Cox, Graham J.
头颈部鳞状细胞癌晚期颈部疾病（N2c/N3）的治疗存在争议。本研究的目的是回顾颈部疾病手术切除后的生存结果和手术并发症。患者和方法回顾性分析了39例在牛津拉德克利夫医院头颈科接受治疗的鳞状细胞癌和晚期颈部转移患者的病例记录，组织学检查证实为pN2c或pN3。在1996年8月至2004年11月期间，患者接受手术治疗，在某些情况下，在中心进行辅助术后放疗。本研究试图建立人口统计学、UICC生存分析。然后在队列和历史对照组之间进行比较。结果所有患者均为UICC IV期疾病。可切除疾病患者的2年和5年总生存率分别为63%和52%。传统上认为晚期颈部疾病患者预后不良，因此治疗方法存在争议。在晚期头颈癌的治疗中，最近出现了从手术转向化疗和/或放疗的趋势。结论：将该研究组与包括化疗和/或放疗的历史对照组进行比较，结果似乎是有利的。提倡使用放射治疗和手术相结合的方法；提示晚期颈部疾病可有可接受的前倾和发病率，可实现局部控制。
INTRODUCTION Treatment of advanced neck disease (N2c/N3) in head and neck squamous cell carcinoma is contentious. The aim of this study was to review the survival outcome following surgical excision of neck disease and the complications of this surgery.PATIENTS AND METHOHDS A retrospective review of the case notes of 39 patients treated at the Oxford Radcliffe Infirmary Head and Neck Unit with squamous cell carcinoma and advanced neck metastases confirmed as either pN2c or pN3 on histological examination was performed. Patients were treated with surgery and in some cases, with adjunctive postoperative radiotherapy at the centre between August 1996 and November 2004. The study sought to establish the demographics, UICC analysis of survival. Comparisions were then made between the cohort and historical control groups.RESULTS All patients were UICC stage IV disease. The 2- and 5-year overall survival in patients with resectable disease was 63% and 52%, respectively.DISCUSSION Patients with advanced neck disease have traditionally been thought to have terrible prognosis and , therefore, tratment is controversial. In trating advanced head and neck cancer, there has been a recent trend away from surgery towards chemotherapy and/or radiotherapy.CONCLUSIONS Comparing this study group to historical controls that include chemotherapy and/or radiotherapy, the outcomes appear favourable. The use of a combination of radiotherapy and surgery is advocated; it is suggested that advanced neck disease can have an acceptable pronosis is and morbidty and that local control may be achieved.