选择性颈清扫对T1,2N0M0舌癌患者预后影响的Meta分析

目的 评价选择性颈清扫对T1,2NOM0舌癌患者预后的影响。材料与方法 检索国内外已公开发表的关于选择性颈清扫对T1,2N0M0舌癌患者预后影响的对照研究,应用Meta分析进行统计学处理。结果 (1)选择性颈清扫对术后复发的影响：符合标准的文献7篇,总样本数742．其中选择性颈清扫组291人,观察组451人。Meta分析结果：选择性颈清扫组相对于观察组的复发优势比OR=0．41,95％可信区间(0．22,0．75),具有统计学意义。(2)选择性颈清扫对术后生存的影响：符合标准的文献5篇,总样本数614,其中选择性颈清扫组222人,观察组392人。Meta分析结果：选择性颈清扫组相对于观察组的生存优势比OR=1．61,95％可信区间(1．14,2．27),具有统计学意义。结论 选择性颈清扫可减少T1,2N0M0舌癌患者术后的复发并能延长生存期。

The efficacy of elective neck dissection on prognosis in T1, 2N0M0 patients with carcinoma of tongue:a meta-analysis

Objective To evaluate the efficacy of elective neck dissection on prognosis in T1,2N0M0 patients with carcinoma of tongue. Materials and methods The efficacy of elective neck dissection on prognosis in T1,2N0M0 patients with carcinoma of tongue continues to be the subject of clinical debate. Currently the clinically negative patients are treated by one of the two main policies: one is elective neck dissection; the other is "watchful waiting". The relative comparative studies published from 1988 to 2003 were searched and adopted by a certain criterion. The meta-analysis software RevMan4.1, applied in Cochrane Library, was used for statistical integration. Results (1)The effectiveness of elective neck dissection for recurrence in T1,2N0M0 patients with carcinoma of tongue: 7 studies were selected. There were totally 742 patients, with 291 cases of elective neck dissection as treatment group, and 451 cases of "watchful waiting" as control group. The odds radio for recurrence between the treatment group and the control group was 0.41, with a 95% confidence interval (0.22,0.75), with statistically significant difference. (2)The effectiveness of elective neck dissection for survival in T1,2N0M0 patients with carcinoma of tongue: 5 studies were selected. There were totally 614 patients: 222 cases of elective neck dissection, and 392 cases of "watchful waiting". The odds radio for survival between the treatment group and the control group was 1.61, with a 95% confidence interval(1.14,2.27), with statistically significant difference. Conclusion Elective neck dissection can reduce recurrence and prolong survival period in T1,2 N0M0 patients with carcinoma of tongue.