N0期舌癌淋巴结清扫治疗与观察的系统评价

Effect of Elective Neck Dissection Verse Watching in the Patients with Tongue Cancer:A Meta-analysis

目的:系统评价对N0期舌癌患者进行选择性颈淋巴结清扫术或者观察治疗的有效性。方法:计算机全面检索(1966～2012年6月年发表的关于)选择性颈淋巴结清扫术对比观察治疗对舌癌患者死亡率以及淋巴结转移率等影响的随机对照试验文献,并严格评价符合纳入文献的质量,用RevMan 5.0软件进行数据分析。结果:最终纳入3个研究,共216例患者。Meta分析结果显示:END(选择性颈淋巴结清扫术)可有效降低N0期舌癌患者的淋巴结转移率,而观察治疗在隐匿性淋巴结转移率结局指标上优于清扫术,其他结局均无统计学差异。结论:END治疗方案比观察治疗方案能明显降低N0期舌癌患者的淋巴结转移率,使淋巴结转移控制在期望的范围内,从而提高了患者生存质量;然而在隐匿性淋巴结的控制方面END方案不及观察治疗方案。

Objective： To assess the effectiveness of evidence regarding the influence of elective neck dissection （END） compared with watching on mortality or metastatic rate of patients with tongue cancer by a recta-analysis. Methods： Computer retrieval was conducted to search for randomly controlled trails （1966-2012.6） comparing elective neck dissection （END） compared with watching. The quality of included studies was critically evaluated and data were analyzed by sing The Cochrane Collaboration＇s RevMan 5.0 software. Results： A total of 3 studies were included in. the Meta-analyses, containing 216 patients. This Meta-analyses showed that there were significant difference between END and watching in the metastatic rate, END decreased it largely. In the other outcomes, END did not show reduction against watching. However, watching was little better to END in the occult metastases. Conclusion： END tends are associated with better therapy results such as metastatic rate among tongue cancer patients in the END compared with watching. These can improve the quantity of life. However, END is not as good as watching in the rate of occult metastases.