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首页> 外文期刊>Sao Paulo Medical Journal >Who are the low-risk patients that could benefit from watch-and-wait regarding the neck?
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Who are the low-risk patients that could benefit from watch-and-wait regarding the neck?

机译：谁能从对颈部的观察和等待中受益的低风险患者？

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CONTEXT AND OBJECTIVE: The management of clinically negative neck is controversial, with an ongoing debate on the indication criteria and prognostic impact of different types of therapy. The aim here was to compare the results from neck dissection and watch-and-wait, among oral cancer patients who, clinically, did not show any evidence of neck metastasis. DESIGN AND SETTING: Retrospective analysis in a tertiary cancer center hospital. METHODS: Patients with epidermoid oral carcinoma were assessed. The inclusion criteria were: primary tumor restricted to the oral/oropharyngeal cavity, no previous treatment, surgical treatment as the first option, clinical/radiological stage N0 and no distant metastasis. RESULTS: Two hundred and sixty-two patients were analyzed. The length of follow-up ranged from four to 369.6 months and, at the end, 118 patients were alive, 53 had died due to cancer, 84 had died from other causes and 7 had died after the operation. Among the patients who underwent neck dissection, lymphatic vascular embolization (P = 0.009) and tumor thickness (P = 0.002) were significant for regional recurrence, while for the watch-and-wait group, only tumor thickness was significant (P = 0.018). Through recursive partitioning, the patients without adverse prognostic factors and tumor thickness < 2 mm presented compatible results in the two groups. CONCLUSION: Elective neck dissection seems to be the best treatment option. Patients who are eligible for watch-and-wait constitute a small group that, ideally, is categorized according to the postoperative pathological findings
机译：语境和目的：临床阴性颈部的治疗存在争议，有关不同类型疗法的适应症标准和预后影响的争论不断。本文的目的是比较临床上未显示任何颈部转移证据的口腔癌患者的颈部解剖和等待观察结果。设计与地点：三级癌症中心医院的回顾性分析。方法：对表皮样口腔癌患者进行评估。纳入标准为：原发性肿瘤局限于口腔/口咽腔，无先前治疗，手术治疗为首选，临床/放射学分期为N0，无远处转移。结果：对262例患者进行了分析。随访时间从4个月到369.6个月不等，最终有118例患者活着，其中53例因癌症死亡，84例因其他原因死亡，7例在手术后死亡。在接受颈淋巴结清扫术的患者中，淋巴管栓塞（P = 0.009）和肿瘤厚度（P = 0.002）对于区域复发是显着的，而对于观察和等待组，只有肿瘤厚度显着（P = 0.018） 。通过递归分配，两组患者均无不良预后因素且肿瘤厚度<2 mm。结论：颈淋巴清扫术似乎是最好的治疗选择。符合观察和等待条件的患者属于一小部分，理想情况下应根据术后病理发现进行分类

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