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对cN0喉及下咽癌患者进行Ⅳ区和Ⅴ区的颈清扫是否合理

Is dissection of levels 4 and 5 justified for cN0 laryngeal and hypopharyngeal cancer?
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摘要 目的:为了制定恰当的颈清扫治疗方案,对cN0喉癌和下咽癌患者的淋巴结累及区域和复发率作一评价。方法:回顾性分析接受局限性颈淋巴结清除术的238例cN0患者,至少随访24个月,并对局部复发进行评估。结果:Ⅳ区的隐匿性淋巴结转移率是3.4%;其中单独转移至Ⅳ区的是1.5%。我们观察发现颈部的局部复发率是5.6%,在Ⅴ区没有发现淋巴结转移和局部复发。结论:当术中颈淋巴结冷冻切片为阴性,对cN0患者可合理性做出Ⅱ、Ⅲ区清扫术,Ⅳ区部分清扫术及对侧颈部淋巴结清扫术,得出结论:Ⅴ区颈清扫术是没有必要的,除非在Ⅴ区有明显的转移灶。
出处 《临床耳鼻咽喉头颈外科杂志》 CAS CSCD 北大核心 2008年第21期998-1001,共4页 Journal of Clinical Otorhinolaryngology Head And Neck Surgery
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