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首页> 外文期刊>American Journal of Clinical Oncology: Cancer Clinical Trials >Incidence of nodal disease after nonsurgical therapy in head and neck squamous cell carcinoma patients with bilateral neck disease: Can a bilateral neck dissection be avoided?
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Incidence of nodal disease after nonsurgical therapy in head and neck squamous cell carcinoma patients with bilateral neck disease: Can a bilateral neck dissection be avoided?

机译：头颈部鳞状细胞癌伴双侧颈部疾病的非手术治疗后淋巴结病的发生率：可以避免双侧颈清扫术吗？

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BACKGROUND: We evaluated whether classifying 1 side of a patients' neck as "high risk" would help in deciding the extent of neck dissection in patients with bilateral nodal disease. METHODS: We conducted a retrospective review of 44 patients (88 heminecks) with head and neck squamous cell carcinoma who had bilateral nodal disease and received definitive chemoradiotherapy (CRT). For lateralized lesions (70%), the ipsilateral neck was designated as the "high-risk" neck. For midline lesions, pre-CRT and post-CRT computed tomography scans were used to stage each side of the neck (hemineck); the higher staged hemineck was designated as the "high-risk" neck. RESULTS: Twenty-seven patients had died at the time of analysis. Patients had a median follow-up of 27.8 months (range, 6 to 150 mo). Two-year neck control and overall survival were 83% and 56%, respectively. Sixty-two heminecks (71%) were dissected. A total of 6/22 (27%) "low-risk" necks were positive after CRT if the "high-risk" neck was positive versus 0/22 if the "high-risk" neck was negative (P=0.02). CONCLUSIONS: Identifying the more "high-risk" neck may be useful when deciding the extent of neck dissection after CRT. For patients with bilateral nodal disease treated with CRT, dissection of the "low-risk" hemineck may be omitted if the "high-risk" neck is pathologically negative.
机译：背景：我们评估了将患者颈部的一侧分类为“高风险”是否有助于确定双侧淋巴结病患者的颈部解剖范围。方法：我们回顾性研究了44例头颈鳞状细胞癌患者（88个颈椎病），这些患者患有双侧淋巴结性疾病并接受了明确的放化疗。对于偏侧病变（70％），同侧颈部被指定为“高危”颈部。对于中线病变，使用CRT之前和CRT之后的计算机X线断层扫描对颈部（颈椎）的每一侧进行分期。较高阶段的羽绒颈被指定为“高风险”颈。结果：在分析时有27名患者死亡。患者的中位随访时间为27.8个月（范围6至150 mo）。两年的颈部控制和总生存率分别为83％和56％。解剖了62个heminecks（71％）。如果“高风险”颈部为阳性，则在CRT后共有6/22（27％）个“低风险”颈部为阳性，而如果“高风险”颈部为阴性，则为0/22（P = 0.02）。结论：确定更“高风险”的颈部可能在确定CRT后颈部清扫范围时很有用。对于接受CRT治疗的双侧淋巴结疾病的患者，如果“高风险”颈部在病理学上是阴性的，则可以省去“低风险”颈部的解剖。

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