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首页> 外文期刊>International journal of oral and maxillofacial surgery >Hemimandibulectomy and therapeutic neck dissection with radiotherapy in the treatment of oral squamous cell carcinoma involving mandible: a critical review of treatment protocol in the years 1994-2004.
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Hemimandibulectomy and therapeutic neck dissection with radiotherapy in the treatment of oral squamous cell carcinoma involving mandible: a critical review of treatment protocol in the years 1994-2004.

机译：半下颌切除术和放射治疗性颈部夹层治疗涉及下颌骨的口腔鳞状细胞癌：1994-2004年治疗方案的重要回顾。

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摘要

This retrospective non-randomized 10-year follow-up study compared 147 patients with squamous cell carcinoma (SCC) of the oral cavity requiring hemimandibulectomy, treated by surgical resection, therapeutic neck dissection and radiotherapy. The 5-year survival rates were compared related to localization, size of the tumour, infiltration of locoregional lymph nodes, distant metastases, histopathological grading, radicality of surgery, and invasion of tumour into the mandible. Occurrence of tumour relapse and its localization was studied. The mean 5-year survival rate was 26%. Patients with SCC of the mandibular alveolar process had higher rates; the lowest rates occurred in SCC of the buccal mucosa. Survival rate was significantly lower with insufficient resection of the tumour (85% relapse). An important number of patients with radical resection died within 3 months of surgery. In almost 55% of the mandibles tumour was not present. In 5% of infiltrated mandibles, dissemination into inferior alveolar nerve was proven. Decreasing survival rate was seen with increasing size of tumour and higher histological grade. Therapeutic neck dissection significantly reduces survival rate and increases the percentage of lymph node relapse. Elective neck dissection should be performed in SCC requiring hemimandibulectomy. Primary reconstruction should reverse the high percentage of postoperative complication arising from increased radicality.
机译：这项为期10年的回顾性非随机随访研究比较了147例需要半下颌切除术的口腔鳞状细胞癌（SCC）患者，并通过手术切除，治疗性颈清扫术和放射疗法进行了治疗。比较了5年生存率与定位，肿瘤大小，局部淋巴结浸润，远处转移，组织病理学分级，手术的彻底性以及肿瘤浸入下颌骨的情况有关。研究了肿瘤复发的发生及其部位。 5年平均生存率为26％。下颌牙槽突SCC患者的发生率较高;发生率最低的是颊粘膜的SCC。肿瘤切除不充分（85％复发）的存活率显着降低。大量接受根治性切除术的患者在手术后3个月内死亡。在下颌骨中几乎没有55％的肿瘤存在。在5％的下颌骨浸润中，已证实可以扩散到下牙槽神经中。随着肿瘤尺寸的增加和组织学等级的提高，存活率降低。颈淋巴结清扫术显着降低了生存率，并增加了淋巴结复发的百分比。在需要半下颌切除术的SCC中应进行颈淋巴清扫术。一次重建应逆转因根治性增加而引起的高比例的术后并发症。

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