Retrospective Study of Selective Submandibular Neck Dissection versus Radical Neck Dissection for N0 or N1 Necks in Level I Patients with Oral Squamous Cell Carcinoma.
Retrospective Study of Selective Submandibular Neck Dissection versus Radical Neck Dissection for N0 or N1 Necks in Level I Patients with Oral Squamous Cell Carcinoma.
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DOI：
10.1155/2012/634183
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发表时间：
2012
影响因子：
--
通讯作者：
Mori Y
中科院分区：
文献类型：
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作者：
Yanai Y;Sugiura T;Imajyo I;Yoshihama N;Akimoto N;Kobayashi Y;Hayashi K;Fujinaga T;Shirasuna K;Takenoshita Y;Mori Y
目标。目的评价选择性下颌下颈淋巴清扫术(SMND)治疗口腔鳞癌(OSCC)伴或不伴淋巴结转移的疗效。病人。在384例接受根治性切除的未经治疗的口腔鳞癌患者中，我们确定了229例临床为N0颈，68例为临床N1颈。主要观察指标。比较SMND、根治性颈淋巴清扫术(RND)和改良根治性颈清扫术(MRND)的Kaplan-Meier 5年区域控制和5年疾病特异性生存(DSS)。结果。在临床淋巴结阴性的颈部，SMND和MRND的区域控制率分别为85.2%和83.3%(P=0.89)，5年DSS率分别为86.5%和87.0%(P=0.94)。在临床N1颈，SMND和RND的区域控制率分别为81.3%和83.0%(P=0.72)，DSS分别为81.3%和80.0%(P=0.94)。采用Cox比例风险模型进行单变量或多变量分析，颈淋巴清扫术类型与区域控制或DSS均无显著相关性。结论。SMND可以有效地应用于临床评估为N0或N1至颈部I级的口腔鳞癌患者的择期和治疗管理。
Objective. To evaluate the efficacy of selective submandibular neck dissection (SMND) in patients with oral squamous cell carcinoma (OSCC) with or without nodal metastasis. Patients. From a total of 384 patients with untreated OSCC who underwent radical excision, we identified 229 with clinically N0 necks and 68 with clinically N1 necks in level I. Main Outcome Measures. The Kaplan-Meier 5-year regional control and 5-year disease specific survival (DSS) were compared for SMND, radical neck dissection (RND), and modified radical neck dissection (MRND). Results. In clinically node-negative necks, the regional control rates were 85.2% with SMND and 83.3% with MRND (P = 0.89), and 5-year DSS rates were 86.5% and 87.0%, respectively, (P = 0.94). In clinically N1 necks, the regional control rates were 81.3% with SMND and 83.0% with RND (P = 0.72), and the DSS rates were 81.3% and 80.0%, respectively, (P = 0.94). Type of neck dissection was not significantly associated with regional control or DSS on either univariate or multivariate analysis using Cox's proportional hazard model. Conclusions. SMND can be effectively applied in elective and therapeutic management to patients with OSCC that are clinically assessed as N0 or N1 to level I of the neck.