IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY
Davide Di Santo, Alessandra Deretti, Vincent Vander Poorten
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引用次数: 0

摘要

综述的目的:腮腺癌的手术治疗因其罕见性、组织学异质性和复杂的区域解剖结构而面临挑战。最近出版的国际指南中包含了原发肿瘤和颈部淋巴结的手术治疗建议,但仍允许以不同的方式对腮腺肿瘤和颈部淋巴结进行治疗。本综述总结了剩余的讨论领域:腮腺癌的参考治疗方法是全腮腺切除术;但对于低级别、低分期肿瘤,浅表腮腺切除术可能就足够了。cN+ 颈部需要进行全面的颈部切除;对于 cN0,仍有多种有价值的选择。对二级结节的冰冻切片分析可以指导颈部切除的范围。对 "边缘清晰 "的定义仍有争议;低级别肿瘤的边缘较近似乎是可以接受的,而边缘阳性则总是需要额外的治疗。总结:透彻理解指南,必要时根据准确的术前检查和术中外科医生的决策进行微调,将为腮腺癌患者带来最佳的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current surgical management of malignant parotid tumors.

Purpose of review: Surgical treatment of parotid cancer presents challenges due to the rarity of the disease, the histologic heterogeneity, and the complex regional anatomy. Recently published international guidelines contain recommendations for surgical management of the primary tumor and the neck lymph nodes, but still allow both T and N to be managed in different ways. This review summarizes the remaining areas of discussion.

Recent findings: The reference treatment for parotid cancer is total parotidectomy; however, for low-grade, low-stage tumors a superficial parotidectomy may be sufficient. The cN+ neck requires a comprehensive neck dissection; for cN0 multiple valuable options remain. Frozen section analysis on level II nodes can guide the extent of neck dissection. The definition of 'clear margins' remains debated; close margins in low-grade tumors appear to be acceptable, positive margins always require additional treatment.

Summary: A thorough understanding of the guidelines, fine-tuned if needed based on accurate preoperative workup and intraoperative surgeon's decision-making will provide the best outcome for the patient with parotid cancer.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
96
审稿时长
6-12 weeks
期刊介绍: Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.
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