未经证实:淋巴结转移使头颈部鳞状细胞癌的生存率降低50%。结节延伸/囊外扩散(ECS)的存在进一步降低了生存率。目前的文献倾向于在临床N0颈部保留选择性水平IIb的颈部清扫术。研究已经评估了原发性肿瘤大小的作用,淋巴结的数量,和浸润深度(DOI)与结外延伸(ENE)的发生。
UNASSIGNED:对口腔癌和临床上为N0颈部的患者进行回顾性分析。寻找肿瘤部位之间的关系,尺寸,组织学分级,DOI,以及IIb级转移和ECS的发生。P<0.05被认为具有统计学意义。
UNASSIGNED:该关系显示与站点之间的P值(0.6643、0.6704、0.6779和0.6779)不相关,尺寸,分级,DOI,以及IIb级和ENE级。
UNASSIGNED:先前的研究表明DOI>5毫米,淋巴结大小15毫米,多个淋巴结可预测ECS。DOI和隐匿性转移超过20%的原发部位可预测选择性颈部治疗。然而,在我们的研究中,未发现原发肿瘤特征与ECS或IIb级转移之间存在相关性.从诊断和治疗的角度来看,选择性颈淋巴结清扫术是标准的手术方案。IIb级解剖的唯一标准是术中伴随存在IIa级参与。由于ENE可以在疾病过程的早期发生,选择性颈淋巴结清扫术仍然是标准的护理。
UNASSIGNED: Nodal metastasis reduces the survival by 50% in head-and-neck squamous cell carcinomas. The presence of nodal extension/extracapsular spread (ECS) further reduces survival. Current literature favors a selective level IIb sparing neck dissection in clinically N0 neck. Studies have evaluated the role of primary tumour size, number of lymph nodes, and depth of invasion (DOI) with the occurrence of extranodal extension (ENE).
UNASSIGNED: Patients were retrospectively reviewed who presented with oral cavity carcinomas and clinically N0 neck. Relationship was sought between tumour site, size, histological grading, DOI, and the occurrence of level IIb metastasis and ECS. A P < 0.05 was considered statistically significant.
UNASSIGNED: The relationship showed insignificant correlation with P values (0.6643, 0.6704, 0.6779, and 0.6779) between site, size, grading, DOI, and level IIb and ENE.
UNASSIGNED: Previous studies have shown DOI >5 mm and lymph node size 15 mm and multiple lymph nodes predict ECS. DOI and primary site with more than 20% for occult metastasis predicts elective neck treatment. However, in our study, no correlation was found between primary tumour characteristics and ECS or level IIb metastasis. Elective neck dissection is the standard surgical protocol from both diagnostic and therapeutic viewpoints. The only criterion for level IIb dissection is concomitant presence of level IIa involvement intraoperatively. Since ENE can occur early in the disease process, elective neck dissection remains the standard of care.