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淋巴闪烁造影引导下颈清扫术诊断 N0 期口腔鳞癌隐匿性转移灶。

Identification of occult metastatic disease via lymphoscintigraphy-guided neck dissection in N0 oral squamous cell carcinoma.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medical College, New York, New York, USA.

出版信息

Head Neck. 2022 Jul;44(7):1596-1603. doi: 10.1002/hed.27059. Epub 2022 Apr 16.

Abstract

BACKGROUND

The purpose of this study is to assess the efficacy of lymphoscintigraphy-guided neck dissection (LSG-ND) in the treatment of N0 oral squamous cell carcinoma.

METHODS

A retrospective cohort study of patients with N0 oral squamous cell carcinoma (SCC) who had either LSG-ND or neck dissection (ND) at our institution between 2008 and 2020.

RESULTS

Eighty-seven patients met criteria with N0 oral squamous cell carcinoma with no previous treatment or neck surgery (27 LSG-ND, 60 ND). Sentinel lymph nodes were identified on the contralateral side in 14.8% of patients with unilateral tumors in the LSG-ND group, with 22.2% of cases with unexpected lymphatic drainage outside ipsilateral levels I-III. No recurrences to date have occurred in the LSG-ND cohort, while 13.3% of patients with ND had regional recurrence (p = 0.04).

CONCLUSIONS

LSG-ND provides a greater ability to identify occult metastatic disease with a significant reduction in regional recurrence in N0 oral SCC.

摘要

背景

本研究旨在评估淋巴闪烁显像引导下颈部清扫术(LSG-ND)治疗 N0 口腔鳞状细胞癌的疗效。

方法

回顾性队列研究纳入了 2008 年至 2020 年在我院接受 LSG-ND 或颈部清扫术(ND)治疗的 N0 口腔鳞状细胞癌(SCC)患者。

结果

87 例符合条件的 N0 口腔 SCC 患者未经前期治疗或颈部手术(27 例 LSG-ND,60 例 ND)。在 LSG-ND 组中,14.8%的单侧肿瘤患者对侧出现前哨淋巴结,22.2%的患者同侧 I-III 水平外出现意外淋巴引流。截至目前,LSG-ND 组无复发病例,而 ND 组有 13.3%的患者出现区域性复发(p=0.04)。

结论

LSG-ND 能够更准确地识别隐匿性转移疾病,显著降低 N0 口腔 SCC 的区域性复发率。

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