临床舌鳞癌N0患者的颈部处理

目的 :探讨舌鳞癌N0 的治疗方法。方法 :对四川大学华西口腔医院 1986～ 1998年间 14 5例舌鳞癌N0患者进行回顾性研究。对T1患者切除原发灶 ,颈部观察 ,对于T2 以上患者或无法随访者采取选择性颈清扫 ,术后随访 3年以上或至死亡。各组间的比较采用卡方检验。结果 :12 3例行选择性颈淋巴清扫术 (END) ,3 3例术后病理证实淋巴结转移 ,2 2例颈部观察组中 4例出现颈淋巴转移。淋巴结隐匿性转移率为 2 5 .5 2 % ,且随临床T分期的增高而增高。总体颈部失控死亡率 ,观察组 (18.18% )与END组 (5 .69% )相比 ,差异有显著性 (P <0 .0 5 )。T1期观察组和END组的颈部失控死亡率分别为 7.69%和 4.5 5 % ,两组间差异无显著性 (P >0 .0 5 ) ,而将T2 、T3 期作为中期病变合并 ,观察组 (3 3 .3 3 % )和END组 (0 % )差异显著 (P <0 .0 0 1)。结论 :舌鳞癌颈部隐匿性转移率较高 ,对T2 期以上N0 舌鳞癌患者应考虑行选择性颈清扫术 ,可提高其颈部控制率和生存率

Treatment of squamous cell carcinoma of tongue with N0

Objective: To analyze the effects of treatment of squamous cell carcinoma of tongue with N 0. Methods: 145 cases of squamous cell carcinoma of tongue with N 0 were retrospectively reviewed.22 cases underwent resection of primary tumor without elective neck dissection (END) (control group).123 cases underwent resection of primary tumor with END (END group).Follow-up was carried out for more than 3 years or till the death of patients.Results:Lymph node metastases was indentified in 33 patients in END group after operation and in 4 in control gruop during follow-up.The total occult lymph node metastases was found in 25.52% of the patients.4 (18.18%) died from neck or lung metastasis in control group and 7 (5.69%) in END group (P<0.05).Conclusion:END may decrease the ratio of metastasis of tongue squamous cell carcinoma.