Prospective study of 583 neck dissections in oral cancers: implications for clinical practice.

Head & Neck Pub Date : 2014-10-01 Epub Date: 2014-01-13 DOI:10.1002/hed.23494

Gouri H Pantvaidya, Pooja Pal, Abhishek D Vaidya, Prathamesh S Pai, Anil K D'Cruz

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引用次数: 54

Abstract

Background: Determining the level of nodal metastases may help decrease the extent of neck dissections and reduce morbidity.

Methods: A prospective study of neck dissections in patients with oral cancer was conducted. Each nodal level was delineated, sent for histopathology, and reported level-wise. Incidence of overall and isolated metastatic nodes at different levels was calculated. Logistic regression was used to find factors predicting metastases to levels IIB and V.

Results: Five hundred eighty-three neck dissections were prospectively evaluated. A total of 95.7% metastases occurred at levels I to IV. Overall incidence of metastases to levels IIB and V was 3.8% and 3.3%, respectively. Multivariate analysis revealed IIA positivity as an independent predictive factor for metastases to both IIB and V.

Conclusion: This study of lymph node mapping in patients with oral cancer showed a predictable pattern of lymph node metastasis according to primary site. Selective neck dissection (levels I-IV) in patients with oral cancers may be adequate. Determining status of level IIA is important to guide dissection of levels IIB and V.

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583例口腔癌颈部解剖的前瞻性研究:对临床实践的启示。

背景:确定淋巴结转移水平可能有助于减少颈部清扫的范围和降低发病率。方法:对口腔癌患者颈部清扫术进行前瞻性研究。每个淋巴结水平被划定，送去组织病理学检查，并逐级报告。计算不同水平的总体和孤立转移淋巴结的发生率。使用Logistic回归寻找预测转移到IIB和v水平的因素。结果:583例颈部解剖进行了前瞻性评估。共有95.7%的转移发生在I至IV级。转移到IIB和V级的总发生率分别为3.8%和3.3%。多因素分析显示，IIA阳性是IIB和v转移的独立预测因素。结论:口腔癌患者的淋巴结作图研究显示，根据原发部位，可以预测淋巴结转移模式。口腔癌患者的选择性颈部清扫(I-IV级)可能是足够的。确定IIA节段的状态对指导IIB和V节段的解剖具有重要意义。

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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Head & Neck

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