Extracapsular Spread in Ipsilateral Neck and Contralateral Neck Metastases in Laryngeal Cancer
Extracapsular Spread in Ipsilateral Neck and Contralateral Neck Metastases in Laryngeal Cancer
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喉癌同侧颈部和对侧颈部转移瘤的囊外扩散
DOI：
10.1177/000348940211100510
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
T. Sunay
中科院分区：
文献类型：
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作者：
Y. Suoğlu;Burak Erdamar;M. Karatay;O. Katircioǧlu;T. Sunay
我们调查了67例同侧淋巴结转移（IpN+）患者的囊外扩散（ECS）发生率和ECS对侧颈部转移的影响，这些患者的记录是从155例喉癌患者中回顾性提取的。ECS的发生率与以下变量相关：T分期、N分期、肿瘤位置、肿瘤范围、阳性淋巴结数量和对侧颈部状态。评估这些变量以确定它们对侧颈部转移（CNM）率和3年生存率的影响。67例患者中，30例（44.7%）患有ECS。ECS阳性与N分期增加、肿瘤向中线延伸、阳性淋巴结数量和CNM之间存在显著相关性（分别为p = 0.04、p = 0.0001、p = 0.018、p = 0.0001）。多变量分析显示，在IpN+中，N分期（p = 0.002;比值比，3.5517）和ECS的存在（p = 0.0036;比值比，7.7840）与CNM的最大风险相关。同侧ECS患者的3年生存率显著低于无ECS患者（43% vs 81%，p = 0.0002）。在考克斯多变量分析中，CNM和IpN+中ECS的存在都是生存率的显著独立预测因素（分别为p = 0.0086和p = 0.0234）。这一结果表明，在IpN+的情况下，用ECS治疗对侧NO颈部是必要的。
We investigated the incidence of extracapsular spread (ECS) and the impact of ECS on contralateral neck metastasis in 67 patients with ipsilateral nodal metastasis (IpN+) whose records were extracted retrospectively from those of 155 laryngeal cancer patients. The incidence of ECS in association with variables was determined: T stage, N stage, tumor location, tumor extension, number of positive nodes, and contralateral neck status. The variables were evaluated to identify their impact on the rates of contralateral neck metastasis (CNM) and 3-year survival. Of the 67 patients, 30 (44.7%) had ECS. A significant relationship was found between ECS positivity and increased N stage, tumor extension up to the midline, number of positive nodes, and CNM (p = .04, p = .0001, p = .018, p = .0001, respectively). Multivariate analysis revealed that N stage (p = .002; odds ratio, 3.5517) and the presence of ECS (p = .0036; odds ratio, 7.7840) in IpN+ were associated with the greatest risk of CNM. The 3-year survival rate of patients with ipsilateral ECS was significantly lower than that of patients without ECS (43% versus 81%, p = .0002). Both CNM and presence of ECS in IpN+ emerged as significant independent predictors for survival with Cox multivariate analysis (p = .0086 and p = .0234, respectively). This result indicates the necessity of treating the contralateral NO neck in cases of IpN+ with ECS.