Correlación clínico patológica de los ganglios cervicales en pacientes con cáncer de cabeza y cuello

Kim Sánchez, Juan Valls
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Abstract

Objective: To correlate the clinical lymph node classification with the pathological result of neck dissections performed in patients with head and neck cancer at the Otorhinolaryngology Department of the Hospital Universitario de Caracas from January 1, 2011 to December 31, 2016. Method: Descriptive, quantitative and retrospective study, which evaluated 27 patients, who underwent classical radical, modified radical and selective neck dissection. Results: average age 56 years, 77.8% male. The most frequent histological type was squamous carcinoma 81.5%. The most used type of dissection was selective 53.3%, followed by the classical radical 26.7% and the modified radical 20.0%, of these 36% presented local or cervical recurrence. Of the 16 patients with positive lymph nodes, 13 had patology confirmation, and all the negative nodes also had negative patology confirmation; regarding cervical recurrence, of the 7 cases where it was present, all positive nodes, and in the 11 patients negative nodes, all negative cervical recurrence. Conclusion: The relationship between the pathological and clinical classification, as well as the presence of positive lymph nodes in cervical recurrences are statistically significant and are related to the decrease in survival. Neck palpation continues to be a useful tool in therapeutic decision making, which has shown higher than average sensitivity and specificity.
头颈部癌症患者颈部淋巴结的临床病理相关性
目的:探讨2011年1月1日至2016年12月31日加拉加斯大学附属医院耳鼻喉科头颈癌患者临床淋巴结分型与颈部清扫病理结果的相关性。方法:采用描述性、定量和回顾性研究方法,对27例接受经典根治术、改良根治术和选择性颈淋巴清扫术的患者进行分析。结果:平均年龄56岁,男性77.8%。最常见的组织学类型为鳞状癌(81.5%)。选择性清扫最多,占53.3%,其次为经典根治法26.7%,改良根治法20.0%,其中36%出现局部或宫颈复发。16例淋巴结阳性患者病理证实13例,阴性淋巴结病理证实均为阴性;宫颈复发方面,7例宫颈淋巴结均为阳性,11例宫颈淋巴结均为阴性,宫颈复发均为阴性。结论:宫颈复发患者的病理分型与临床分型、有无淋巴结阳性均有统计学意义,且与生存率降低有关。颈部触诊仍然是治疗决策的有用工具,显示出高于平均水平的敏感性和特异性。
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