Selective neck dissection of level IIB in cN0 laryngeal cancer: a systematic review and meta-analysis.

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2024-12-16 DOI:10.1007/s00405-024-09145-3

Simone Mauramati, Maria Vittoria Veneroni, Eugenio Errico, Pietro Canzi, Giulia Bertino, Emanuele Robiolio, Rebecca Gelli, Fabio Pedretti, Marta Minuti, Rita Crea, Marco Benazzo

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引用次数: 0

Abstract

Purpose: The primary endpoint of the study was to quantitatively evaluate the presence of IIB neck level metastases in patients with laryngeal carcinoma, to provide valuable evidence to aid surgeons in the decision-making process for neck dissections. As a secondary aim this study analyzed the presence of factors that may be associated with a higher prevalence of metastasis.

Methods: Two independent authors (EE, MVV) searched for articles on PubMed, Cochrane, Embase, and Scopus databases. Review of the articles was carried out following 2020 PRISMA guidelines, all articles were assessed for quality according to NICE guidelines. Afterwards the statistical analysis was performed with STATA 18SE software. Studies were also assessed for heterogeneity and risk of publication bias.

Results: A total of 19 studies were included, from which data on 1205 subjects was extracted. Out of 997 patients with a cN0 LC, 21 patients developed metastasis. This meta-analysis found the cumulative rate of metastasis to be 1% (95% CI 0-2%). Also, there is a 51% higher probability (OR: 1.51, 95% CI 0.06, 2.92) of occult IIB metastasis in higher stages (T3/T4) compared to lower stages (T1/T2).

Conclusions: Dissection of level IIB may be safely spared in patients with cN0 laryngeal cancer, possibly leading to improved QoL and shoulder function as well as reducing OR times and costs.

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目的：本研究的主要目的是定量评估喉癌患者是否存在 IIB 颈部水平转移，为外科医生进行颈部切除术的决策过程提供有价值的证据。本研究的第二个目的是分析是否存在可能与转移发生率较高相关的因素：两位独立作者（EE、MVV）在 PubMed、Cochrane、Embase 和 Scopus 数据库中搜索文章。根据 2020 年 PRISMA 指南对文章进行了审查，并根据 NICE 指南对所有文章进行了质量评估。然后使用 STATA 18SE 软件进行统计分析。此外，还对研究的异质性和发表偏倚风险进行了评估：共纳入 19 项研究，从中提取了 1205 名受试者的数据。在997例cN0 LC患者中，有21例发生了转移。这项荟萃分析发现，转移的累积率为 1%（95% CI 0-2%）。此外，与低分期（T1/T2）相比，高分期（T3/T4）发生隐匿性 IIB 转移的概率高出 51%（OR：1.51，95% CI 0.06，2.92）：结论：对于cN0喉癌患者来说，可以安全地避免IIB水平的切除，这可能会改善患者的生活质量和肩部功能，并减少手术时间和费用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.