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首页> 外文期刊>British journal of oral & maxillofacial surgery >Evolving role of modifications in neck dissection for oral squamous carcinoma
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Evolving role of modifications in neck dissection for oral squamous carcinoma

机译：修饰在口腔鳞癌颈清扫术中的作用

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Surgical nianagement of the neck in patients with oral cancer should be based upon the known risk factors for neck metastasis (tumour location, size, and thickness) and the knowledge of patterns of nodal metastasis from these lesions. In patients clinically staged N_0 the nodal levels at risk are Ⅰ-Ⅲ, while in those clinically N _+ the levels at risk are Ⅰ- Ⅳ. The posterior triangle (level Ⅴ) is seldom involved by metastases from these lesions. Using this information a rational approach to surgical therapy can be developed. In the clinically N_0 patient SOHND is adequate. It is therapeutic for pathologically negative nodes, and provides sufficient information to consider postoperative radiation therapy in pathologically positive nodes. In N_+ patients comprehensive neck dissection with preservation of the SAN if possible is advised. The decision regarding postoperative radiation therapy should be based upon ominous pathologic findings such as multiple positive nodes and/or the presence of ECS. The use of postoperative radiation therapy in the patient with one positive node without ECS is less clear although it may be of benefit.
机译：口腔癌患者的颈部外科手术治疗应基于已知的颈部转移危险因素（肿瘤位置，大小和厚度）以及对这些病变的淋巴结转移方式的了解。在临床分期的N_0患者中，淋巴结的高危水平为Ⅰ-Ⅲ，而在临床上的N_ +患者的淋巴结的高危水平为Ⅰ-Ⅳ。这些病变的转移很少涉及到后三角区（Ⅴ级）。利用该信息，可以开发出合理的手术治疗方法。在临床上，N_0位患者的SOHND就足够了。它对病理学阴性的淋巴结具有治疗作用，并提供了足够的信息来考虑对病理学阳性的淋巴结进行术后放射治疗。在N_ +位患者中，建议进行颈部全切术并尽可能保留SAN。有关术后放射治疗的决定应基于不祥的病理学发现，例如多个阳性淋巴结和/或ECS的存在。尽管有好处，但在没有ECS的一个阳性淋巴结阳性的患者中使用术后放射疗法尚不清楚。

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