PDF(Pubmed)
Abstract：
UNASSIGNED: After improvement in the treatment of oral cancers over the years we now see more patients with recurrent oral squamous cell carcinoma (OSCC) and second primary. Recommendations for addressing the neck (ipsilateral and/or contralateral) in these patients are still unclear and debatable.
UNASSIGNED: In this retrospective study we included patients with recurrent and second primary OSCC who underwent surgery between January 2016 and December 2021. We analysed to identify factors and better imaging modality that help predict a pathologically N + neck in these patients.
UNASSIGNED: In our cohort of 219 patients treated for recurrent/second primary OSCC, 131 patients underwent a neck dissection along with surgery for primary, out of which 59 patients had pN + neck. Factors that predicted ipsilateral pN + status were the clinical stage (advanced) p = 0.009, 2.724(1.291-5.750), subsite (Tongue + floor of mouth) p = 0.01, 3.105(1.305-7.386), previous treatment received (surgery alone) p = 0.0472.148(1.011-4.562) and histopathology [poorly differentiated squamous cell carcinoma (PDSCC)] p = 0.014, 3.070(1.253-7.519). PET-CECT had the best agreement (p < 0.001, kappa = 0.742) to predict nodal metastasis. There were no factors that could predict contralateral nodal metastasis.
UNASSIGNED: Patients with advanced clinical stage, Tongue + floor of mouth subsite, only surgery done previously, and histopathology (PDSCC) had a higher incidence of ipsilateral nodal metastasis in our cohort.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12663-024-02272-8.
UNASSIGNED: In this retrospective study we included patients with recurrent and second primary OSCC who underwent surgery between January 2016 and December 2021. We analysed to identify factors and better imaging modality that help predict a pathologically N + neck in these patients.
UNASSIGNED: In our cohort of 219 patients treated for recurrent/second primary OSCC, 131 patients underwent a neck dissection along with surgery for primary, out of which 59 patients had pN + neck. Factors that predicted ipsilateral pN + status were the clinical stage (advanced) p = 0.009, 2.724(1.291-5.750), subsite (Tongue + floor of mouth) p = 0.01, 3.105(1.305-7.386), previous treatment received (surgery alone) p = 0.0472.148(1.011-4.562) and histopathology [poorly differentiated squamous cell carcinoma (PDSCC)] p = 0.014, 3.070(1.253-7.519). PET-CECT had the best agreement (p < 0.001, kappa = 0.742) to predict nodal metastasis. There were no factors that could predict contralateral nodal metastasis.
UNASSIGNED: Patients with advanced clinical stage, Tongue + floor of mouth subsite, only surgery done previously, and histopathology (PDSCC) had a higher incidence of ipsilateral nodal metastasis in our cohort.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12663-024-02272-8.
摘要：
■经过多年的口腔癌治疗改善，我们现在看到更多的复发性口腔鳞状细胞癌（OSCC）和第二原发患者。这些患者的颈部（同侧和/或对侧）的建议仍不清楚且有争议。
在这项回顾性研究中，我们纳入了在2016年1月至2021年12月期间接受手术的复发性和第二原发性OSCC患者。我们进行了分析，以确定有助于预测这些患者病理N颈的因素和更好的成像方式。
■在我们的219例因复发性/第二原发性OSCC接受治疗的患者队列中，131例患者接受了颈淋巴结清扫术以及原发性手术，其中59例患者为pN+颈部。预测同侧pN+状态的因素是临床分期（晚期）p=0.009，2.724（1.291-5.750），亚中心(舌层+口层)p=0.01，3.105(1.305-7.386)，既往接受过治疗(单纯手术)p=0.0472.148(1.011-4.562),组织病理学[低分化鳞状细胞癌(PDSCC)]p=0.014,3.070(1.253-7.519).PET-CECT预测淋巴结转移的一致性最好(p<0.001,κ=0.742)。没有可以预测对侧淋巴结转移的因素。
■临床晚期患者，舌部+口底以前只做过手术,在我们的队列中,组织病理学(PDSCC)的同侧淋巴结转移发生率较高.
■在线版本包含补充材料，可在10.1007/s12663-024-02272-8获得。
在这项回顾性研究中，我们纳入了在2016年1月至2021年12月期间接受手术的复发性和第二原发性OSCC患者。我们进行了分析，以确定有助于预测这些患者病理N颈的因素和更好的成像方式。
■在我们的219例因复发性/第二原发性OSCC接受治疗的患者队列中，131例患者接受了颈淋巴结清扫术以及原发性手术，其中59例患者为pN+颈部。预测同侧pN+状态的因素是临床分期（晚期）p=0.009，2.724（1.291-5.750），亚中心(舌层+口层)p=0.01，3.105(1.305-7.386)，既往接受过治疗(单纯手术)p=0.0472.148(1.011-4.562),组织病理学[低分化鳞状细胞癌(PDSCC)]p=0.014,3.070(1.253-7.519).PET-CECT预测淋巴结转移的一致性最好(p<0.001,κ=0.742)。没有可以预测对侧淋巴结转移的因素。
■临床晚期患者，舌部+口底以前只做过手术,在我们的队列中,组织病理学(PDSCC)的同侧淋巴结转移发生率较高.
■在线版本包含补充材料，可在10.1007/s12663-024-02272-8获得。
