The strategy on managing cervical lymph nodes of patients with maxillary gingival squamous cell carcinoma
The strategy on managing cervical lymph nodes of patients with maxillary gingival squamous cell carcinoma
复制标题
上颌牙龈鳞癌患者颈部淋巴结的处理策略
DOI：
10.1016/j.jcms.2018.12.008
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发表时间：
2019-02-01
影响因子：
3.1
通讯作者：
Qin, Lizheng
中科院分区：
文献类型：
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作者：
Qu, Yi;Liu, Yanbin;Qin, Lizheng
目的：我们的目的是确定上颌牙龈鳞状细胞癌（SCC）的颈部隐匿性转移的风险，颈部隐匿性转移的易感因素和选择性颈淋巴结清扫术（END）的治疗价值在临床阴性的颈部淋巴结（cN 0）patients.Methods：上颌牙龈SCC患者的回顾性研究在我院进行。收集并分析临床信息，包括年龄、性别、TNM分期、病理分期以及其他人口统计学和临床数据。Kaplan-Meier法评价总生存率。结果：样本由107名患者组成（43名男性，64名女性）。淋巴结转移率为28%。T1 ~ T4期肿瘤的淋巴结转移率分别为7.1%、15%、41.7%和44.8%; I ~ III级肿瘤的淋巴结转移率分别为9.3%、46.8%和50%。肿瘤分期、病理分级与颈淋巴结转移密切相关（P < 0.01）。END组5年生存率（76%）高于未接受END组（46.4%，P < 0.05）。pN 0组的生存率高于pN +组（P < 0.01）。结论：本研究结果提示，上颌牙龈来源的SCC发生LNM的风险高于预期，与口腔其他部位的SCC发生LNM的风险相当。我们推荐END用于T3和T4期cN 0患者，尤其是中分化和低分化肿瘤。(C)2018年欧洲颅颌面外科协会。由爱思唯尔有限公司出版。保留所有权利。
Purpose: We aimed to determine the risk of occult cervical metastasis of maxillary gingival squamous cell carcinoma (SCC), the predisposing factors for occult cervical metastasis and the therapeutic value of elective neck dissection (END) in survival of clinically negative neck node (cN0) patients.Methods: A retrospective study of patients with maxillary gingival SCC was conducted in our hospital. Clinical information including age, gender, TNM staging, pathological staging, as well as other demographic and clinical data was acquired and analyzed. The Kaplan-Meier method was used to evaluate overall survival rate. Descriptive and bivariate statistics were computed.Results: The sample was composed of 107 patients (43 men, 64 women). The overall lymph node metastasis (LNM) rate was 28%. The LNM rates were 7.1%, 15%, 41.7% and 44.8% for T1 to T4 stage tumors, and were 9.3%, 46.8%, and 50% for pathological grades I to III. The tumor stage and pathological grade showed a significant relationship with cervical metastasis (P < 0.01). The 5-year survival rate was higher in those who had an END (76%) when compared to those who did not receive an END (46.4%; P < 0.05). With regard to the nodal status, pN0 group had a higher survival rate than pN + group (P < 0.01).Conclusion: The results of this study suggest that the risk of LNM for SCC originating from the maxillary gingiva is higher than expected and comparable to that for other oral sites. We recommend END for T3 and T4 stage cN0 patients, especially for moderately and poorly-differentiated tumors. (C) 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.