颈侧清扫术与颈改良根治性清扫术在喉癌cN1治疗中的应用

目的:对比分析颈侧清扫术(lateral neck dissection,LND)与改良根治性颈清扫术(modified neck dissection,MND)在治疗喉癌临床N1(clinical N1,cN1)患者中的效果.方法:回顾性分析51例伴cN1期颈淋巴结转移的喉癌患者的临床资料,Kaplan-Meier法统计累积生存率,Log-rank检验比较LND组(37例)和MND组(14例)的生存率.结果:LND组和MND组的5年生存率分别为89.2%和85.7%(P＞0.05);5年颈淋巴复发率分别为2.7%和0%(P＞0.05);而LND组与颈清扫有关的并发症的发生率为8.1%,明显低于MND组的42.9%(P＜0.01);两组的平均住院时间为25 d和32 d(P＜0.05).结论:与改良根治性颈清扫术相比,采用颈侧清扫术不影响cN1喉癌患者的疗效,同时降低了并发症的发生率,缩短了住院时间.

Lateral Neck Dissection and Modified Neck Dissection in the Treatment of Clinical N1 Laryngeal Carcinoma

Objective： To compare the effectiveness of lateral neck dissection （LND） with modified radical dissection （MND） for the treatment of clinical N1 laryngeal carcinoma. Methods ：51patients with clinical N1 laryngeal carcinoma were retrospectively analyzed. Kaplan - Meier method was used to estimate the survival analysis and Log - rank method for comparison of different distribution of the several influential factors of the survival. Results：The 5 -year survival rates for LND and MND were 89.2% and 85.7% respectively, there was no statistical difference. The neck recurrence for LND was 2.7% , which was not statistically different from the neck recurrence in the MND （0.0%）. Complications and times of hospitalization were both decreased in LND group and MND group （8.1% and 42.9, 25d and 32d）. Conclusions：Compared with MND, the LND offers the same therapeutic effect and fewer complications and less period of hospitalization for patients with clinical N1 laryngeal carcinoma.