PDF(Pubmed)
Abstract：
BACKGROUND: The accurate indication for level IV dissection is crucial for preventing complications such as phrenic nerve damage and chylous fistulas in clinically N0 tongue cancer. Although the depth of invasion is an established independent risk factor for occult lymph node metastasis in tongue cancer, its relationship with level IV metastasis has not been evaluated. This study investigated the relationship between the depth of invasion and level IV nodal metastasis in clinically N0 tongue cancer.
METHODS: We retrospectively investigated clinical N0 patients who underwent glossectomy and level I-IV neck dissection. We examined lymph node metastasis, risk factors, and the relationship between depth of invasion and metastasis.
RESULTS: Our study included 58 patients, and no patient had isolated level IV metastasis. Additionally, there was no level IV metastasis in well-differentiated tumors. Tumor size, depth of invasion, differentiation, and perineural invasion were significantly associated with level IV neck metastasis. We found a critical tumor size of 2.5 cm and depth of invasion of 8 mm for level IV neck metastasis.
CONCLUSIONS: Based on our findings, we recommend that level IV dissection should be considered for poorly differentiated tumors, tumors greater than 2.5 cm in size, and those deeper than 8 mm. This study highlights the importance of depth of invasion as a prognostic factor for predicting level IV metastasis and suggests that our findings can be used to prevent unnecessary level IV dissections that may lead to complications in tongue cancer surgery.
METHODS: We retrospectively investigated clinical N0 patients who underwent glossectomy and level I-IV neck dissection. We examined lymph node metastasis, risk factors, and the relationship between depth of invasion and metastasis.
RESULTS: Our study included 58 patients, and no patient had isolated level IV metastasis. Additionally, there was no level IV metastasis in well-differentiated tumors. Tumor size, depth of invasion, differentiation, and perineural invasion were significantly associated with level IV neck metastasis. We found a critical tumor size of 2.5 cm and depth of invasion of 8 mm for level IV neck metastasis.
CONCLUSIONS: Based on our findings, we recommend that level IV dissection should be considered for poorly differentiated tumors, tumors greater than 2.5 cm in size, and those deeper than 8 mm. This study highlights the importance of depth of invasion as a prognostic factor for predicting level IV metastasis and suggests that our findings can be used to prevent unnecessary level IV dissections that may lead to complications in tongue cancer surgery.
摘要：
背景：IV级解剖的准确指征对于预防临床上NO舌癌的并发症，如膈神经损伤和乳糜瘘至关重要。尽管浸润深度是舌癌隐匿性淋巴结转移的独立危险因素，尚未评估其与IV级转移的关系。本研究调查了临床N0舌癌的浸润深度与IV级淋巴结转移之间的关系。
方法：我们回顾性调查了临床N0例患者行舌叶切除术和I-IV级颈清扫术。我们检查了淋巴结转移，危险因素，浸润深度与转移的关系。
结果：我们的研究包括58名患者，并且没有患者有孤立的IV级转移。此外,高分化肿瘤无IV级转移.肿瘤大小,入侵深度,分化,神经周浸润与IV级颈部转移显著相关。我们发现IV级颈部转移的临界肿瘤大小为2.5cm，浸润深度为8mm。
结论：根据我们的发现，我们建议对于低分化肿瘤应考虑进行IV级解剖，肿瘤大小大于2.5厘米，和那些深度超过8毫米的。这项研究强调了侵袭深度作为预测IV级转移的预后因素的重要性，并表明我们的发现可用于预防可能导致舌癌手术并发症的不必要的IV级解剖。
方法：我们回顾性调查了临床N0例患者行舌叶切除术和I-IV级颈清扫术。我们检查了淋巴结转移，危险因素，浸润深度与转移的关系。
结果：我们的研究包括58名患者，并且没有患者有孤立的IV级转移。此外,高分化肿瘤无IV级转移.肿瘤大小,入侵深度,分化,神经周浸润与IV级颈部转移显著相关。我们发现IV级颈部转移的临界肿瘤大小为2.5cm，浸润深度为8mm。
结论：根据我们的发现，我们建议对于低分化肿瘤应考虑进行IV级解剖，肿瘤大小大于2.5厘米，和那些深度超过8毫米的。这项研究强调了侵袭深度作为预测IV级转移的预后因素的重要性，并表明我们的发现可用于预防可能导致舌癌手术并发症的不必要的IV级解剖。
