301例口腔癌颈部淋巴结处理的随访研究

目的　评价口腔癌的发生部位和TNM分期对颈淋巴结转移及外科处理的影响。方法随访 30 1例首诊治疗口腔癌患者 ,计算颈淋巴结转移病理检出率、单纯原发灶切除后颈淋巴结复发率、颈淋巴清扫后颈淋巴结复发率。结果　病理转移检出率 41 6 % ,舌、口底、下龈、颊癌单纯原发灶切除后淋巴结复发率 32 1% ,功能性颈淋巴清扫术后复发率 14 7%。结论　TNM分期是临床判断淋巴结转移的有效依据 ,对发生于上述 4个部位的鳞癌应扩大选择性颈淋巴清扫的适应证 ,选择功能性颈淋巴清扫术需慎重

Surgical treatment of cervical lymph nodes in 301 patients with oral squamous cell carcinoma

Objective To evaluate cervical lymph metastases and its surgical treatment of oral carcinoma with regard to primary location and TNM classification Methods 301 previously untreated patients were included in the follow up study to calculate the rate of histopathologically positive lymph metastasis and the rate of recurrences in untreated necks and after FND (functional neck dissection) Results Lymph node pathologic positive rates were N 0 7 4%, N 1 14 7%, N 2 76 2% Recurrences occurred in 32 1% untreated necks and 14 7% necks after FND of carcinomas of tongue, bucca, lower gingiva and oral floor, while rarely in necks of carcinomas of palate and upper gingiva Conclusions TNM classification is useful to estimate lymph metastasis Application of elective neck dissection needs to expand in carcinomas of the above four sites It should be careful when choose FND