Residual nodal disease in patients with advanced-stage oropharyngeal squamous cell carcinoma treated with definitive radiation therapy and posttreatment neck dissection: Association with locoregional recurrence, distant metastasis, and decreased survival
Residual nodal disease in patients with advanced-stage oropharyngeal squamous cell carcinoma treated with definitive radiation therapy and posttreatment neck dissection: Association with locoregional recurrence, distant metastasis, and decreased survival
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DOI：
10.1002/hed.23173
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发表时间：
2013-10-01
影响因子：
2.9
通讯作者：
Myers, Jeffrey N.
中科院分区：
文献类型：
--
作者：
Sandulache, Vlad C.;Ow, Thomas J.;Myers, Jeffrey N.
背景：口咽鳞状细胞癌（OPSCC）的发病率正在上升。我们回顾了接受放化疗的晚期OPSCC患者，以评估残留颈部疾病对生存的影响。方法回顾性分析1990年至2010年间，202例首次放化疗后颈部清扫的OPSCC患者。影像学分析采用RECIST (Response Evaluation Criteria In Solid Tumors) 1.1标准。生存率评估采用单因素和多因素分析。结果5年生存率为89%。42例（21%）患者存在颈部残留病变（pN+）。pN+与更大的局部复发（LRR）和远处转移（DM）以及生存降低相关。没有临床病理因素预测pN+。对比后处理CT敏感性和特异性较低。结论在晚期OPSCC pN+患者中，LRR和DM的发生率较高，临床病理因素和治疗后影像学均不能预测pN+，尽管现代影像学的使用增加可能会降低阴性颈部清扫的发生率。(c) 2012 Wiley期刊有限公司中国生物医学工程学报，2013,31 (2):444 - 444
BackgroundOropharyngeal squamous cell carcinoma (OPSCC) is increasing in frequency. We reviewed patients with advanced-stage OPSCC treated with chemoradiation to assess the impact of residual neck disease on survival.MethodsWe reviewed 202 patients with OPSCC between 1990 and 2010 treated with primary chemoradiation followed by neck dissection. Imaging was analyzed using RECIST (Response Evaluation Criteria In Solid Tumors) 1.1 criteria. Survival was evaluated using both univariate and multivariate analyses.ResultsOverall survival at 5 years was 89%. Forty-two patients (21%) had residual disease in the neck (pN+). pN+ was associated with greater locoregional recurrence (LRR) and distant metastasis (DM) and decreased survival. No clinicopathologic factors were predictive of pN+. Contrasted posttreatment CT had low sensitivity and specificity.ConclusionsIn advanced OPSCC pN+, patients have higher rates of LRR and DM. Neither clinicopathologic factors nor posttreatment imaging was predictive of pN+, although increased use of modern imaging may reduce the rate of negative neck dissections. (c) 2012 Wiley Periodicals, Inc. Head Neck 35: 1454-1460, 2013