Abstract：
Our objective is to assess the oncologic outcomes of observation, elective neck dissection (END), and elective neck irradiation (ENI) in the neck management of head and neck cutaneous squamous cell carcinoma (HNcSCC) with parotid metastasis (P+) and to evaluate the quality of life (QoL) of patients who received END or ENI.
Patients with P+ HNcSCC were retrospectively enrolled. The impact of observation, END, and ENI on regional control (RC) and overall survival (OS) was analyzed using Cox proportional hazards model with presentation via hazard ratio (HR) with a 95% confidence interval (CI). QoL was evaluated using the University of Washington Quality of Life questionnaire.
A total of 134 patients were included in our analysis. In the Cox model for RC, both END and ENI had decreased HRs of 0.27 (95% CI: 0.15-0.69) and 0.34 (95% CI: 0.18-0.86), respectively, in comparison with observation. In the Cox model for OS, both END (p = 0.001, HR: 0.22, 95% CI: 0.10-0.72) and ENI (p = 0.006, HR: 0.30, 95% CI: 0.17-0.83) were superior to observation. In patients with three or more positive parotid lymph nodes, END resulted in significantly better RC (p < 0.001) and OS (p = 0.001) compared with ENI. The two groups were found to be comparable in all 12 domains of the University of Washington Quality of Life questionnaire.
In the neck management of P+ HNcSCC, observation is not recommended. END is the preferred option, but ENI is an alternative method without compromise to survival or QoL, except in cases with three or more metastatic parotid lymph nodes.
Patients with P+ HNcSCC were retrospectively enrolled. The impact of observation, END, and ENI on regional control (RC) and overall survival (OS) was analyzed using Cox proportional hazards model with presentation via hazard ratio (HR) with a 95% confidence interval (CI). QoL was evaluated using the University of Washington Quality of Life questionnaire.
A total of 134 patients were included in our analysis. In the Cox model for RC, both END and ENI had decreased HRs of 0.27 (95% CI: 0.15-0.69) and 0.34 (95% CI: 0.18-0.86), respectively, in comparison with observation. In the Cox model for OS, both END (p = 0.001, HR: 0.22, 95% CI: 0.10-0.72) and ENI (p = 0.006, HR: 0.30, 95% CI: 0.17-0.83) were superior to observation. In patients with three or more positive parotid lymph nodes, END resulted in significantly better RC (p < 0.001) and OS (p = 0.001) compared with ENI. The two groups were found to be comparable in all 12 domains of the University of Washington Quality of Life questionnaire.
In the neck management of P+ HNcSCC, observation is not recommended. END is the preferred option, but ENI is an alternative method without compromise to survival or QoL, except in cases with three or more metastatic parotid lymph nodes.
摘要：
目的：我们的目的是评估肿瘤的观察结果，选择性颈淋巴结清扫术(END),和选择性颈部放疗（ENI）在头颈部皮肤鳞状细胞癌（HNcSCC）伴腮腺转移（P）的颈部管理中，并评估接受END或ENI的患者的生活质量（QoL）。
方法：回顾性纳入P+HNcSCC患者。观察的影响，结束,使用Cox比例风险模型分析区域控制(RC)和总生存期(OS)的ENI,并通过风险比(HR)和95%置信区间(CI)呈现.使用华盛顿大学生活质量问卷评估QoL。
结果：共134例患者纳入我们的分析。在RC的Cox模型中，END和ENI的HR均降低了0.27（95%CI：0.15-0.69）和0.34（95%CI：0.18-0.86），分别,与观察相比。在OS的Cox模型中，END(p=0.001,HR:0.22,95%CI:0.10-0.72)和ENI(p=0.006,HR:0.30,95%CI:0.17-0.83)均优于观察。在有三个或更多腮腺淋巴结阳性的患者中，与ENI相比,END产生显著更好的RC(p<0.001)和OS(p=0.001)。发现两组在华盛顿大学生活质量问卷的所有12个领域中具有可比性。
结论：在P+HNcSCC的颈部管理中，不建议观察。END是首选选项，但是ENI是一种不影响生存或QoL的替代方法，除了有三个或更多转移性腮腺淋巴结的病例。
方法：回顾性纳入P+HNcSCC患者。观察的影响，结束,使用Cox比例风险模型分析区域控制(RC)和总生存期(OS)的ENI,并通过风险比(HR)和95%置信区间(CI)呈现.使用华盛顿大学生活质量问卷评估QoL。
结果：共134例患者纳入我们的分析。在RC的Cox模型中，END和ENI的HR均降低了0.27（95%CI：0.15-0.69）和0.34（95%CI：0.18-0.86），分别,与观察相比。在OS的Cox模型中，END(p=0.001,HR:0.22,95%CI:0.10-0.72)和ENI(p=0.006,HR:0.30,95%CI:0.17-0.83)均优于观察。在有三个或更多腮腺淋巴结阳性的患者中，与ENI相比,END产生显著更好的RC(p<0.001)和OS(p=0.001)。发现两组在华盛顿大学生活质量问卷的所有12个领域中具有可比性。
结论：在P+HNcSCC的颈部管理中，不建议观察。END是首选选项，但是ENI是一种不影响生存或QoL的替代方法，除了有三个或更多转移性腮腺淋巴结的病例。
