[Strategy of neck dissection in parotid cancer].
[Strategy of neck dissection in parotid cancer].
复制标题
腮腺癌颈清扫术策略[J].
DOI：
10.3950/jibiinkoka.105.178
复制
发表时间：
2002
期刊：
影响因子：
--
通讯作者：
S. Yoshimoto
中科院分区：
文献类型：
--
作者：
T. Beppu;S. Kamata;K. Kawabata;T. Nigauri;K. Hoki;H. Mitani;S. Yoshimoto
从1975年至1995年，我们对45例未经治疗的原发性腮腺癌患者进行了确定性手术，并对颈清扫术的方法和治疗结果进行了评价。14例临床颈淋巴结转移患者均行同侧颈淋巴结清扫术，仅1例周边清扫部位颈淋巴结复发。在31例无颈淋巴结转移的患者中，27/19例高度恶性，12/24例T3或T4未行预防性颈淋巴结清扫，2例（7.4%）发生潜伏性颈淋巴结转移。而大多数情况下，我们取得了良好的控制原发部位，但颈部淋巴结复发，观察到的同侧颈部周围的复发部位和预后很差，如果进行颈淋巴结清扫术作为第二次治疗。虽然组织病理学诊断被认为是预测隐匿性颈淋巴结转移的可行方法，但细针穿刺细胞学诊断的正确率仅为21.8%。15例颈淋巴结清扫术后病理阳性淋巴结在同侧颈淋巴结I ~ V层全部检出，II层复发阳性率为100%。根据上述结果，我们得出结论：（1）在术前评估中有颈淋巴结转移的病例中，应强制进行同侧根治性颈清扫术;（2）在无颈淋巴结转移的病例中，通常不需要进行预防性颈清扫术。当术中颈静脉二腹肌淋巴结取样的冰冻切片病理结果为阳性时，要求进行同侧根治性颈淋巴结清扫术。
We conducted definitive surgery on 45 patients with untreated primary parotid cancer from 1975 to 1995, and evaluated methods of neck dissection and results of treatment. All 14 with clinical neck lymph node metastasis underwent ipsilateral radical neck dissection and only 1 developed neck lymph node recurrence at the peripheral dissected site. Of 31 patients without clinical neck lymph node metastasis, 27 of 19 of 36 with high-grade malignancy and 12 of 24 with T3 or T4 did not undergo prophylactic neck dissection and developed latent neck lymph node metastasis in 2 cases (7.4%). Whereas in most cases we achieved good control of the primary site but neck lymph node recurrences occurred, recurrent sites were observed all around the ipsilateral neck and prognosis were very poor if neck dissection was conducted as secondary treatment. Although histopathological diagnosis was considered feasible for predicting occult neck lymph node metastasis, correct diagnostic with fine needle aspiration cytology revealed only 21.8%. Pathological positive lymph nodes in 15 patients who underwent neck dissection were detected all over (level I to V) the ipsilateral neck and the recurrent positive rate at level II was 100%. Based on the above results, we conclude that (1) in cases with neck lymph node metastasis in preoperative evaluation, ipsilateral radical neck dissection is mandated, and (2) in cases without neck lymph node metastasis, prophylactic neck dissection is not usually needed. When pathological results of frozen section from intraoperative jugulodigastric nodal sampling are positive, ipsilateral radical neck dissection is mandated.
DOI：
10.1002/hed.2890080309
发表时间：
1986-01-01
期刊：
HEAD & NECK SURGERY
影响因子：
--
作者：
SPIRO, RH
通讯作者：
SPIRO, RH