共查询到20条相似文献，搜索用时 15 毫秒
1.
Roman Kia Rahimi-Nedjat Bilal Al-Nawas Andrea Tuettenberg Keyvan Sagheb Stephan Grabbe Christian Walter 《Journal of cranio-maxillo-facial surgery》2018,46(6):1027-1031
Background
The aim of this retrospective study was to investigate sentinel lymph node biopsy in patients with head and neck melanoma.Materials and methods
Patients who underwent SLNB between 2010 and 2016 were comprised. Epidemiological, radiological, and surgical data were collected and compared to histological findings. Patients who underwent primary complete lymph node dissection were excluded.Results
74 patients underwent SLNB during this period. The most common tumor localizations were the cheek (20.4%) and ears (20.4%). Overall, 256 sentinel lymph nodes (SLN) were detected and removed, most frequently in Robbins-levels IIA and IIB as well as in the surrounding of the parotid gland. 12.3% of the SLN showed a microscopic or macroscopic metastasis. In preoperative imaging all lymph nodes with macroscopic metastasis were described as suspect but only 4 of 11 lymph nodes with microscopic metastases were described as such.Conclusions
SLNB is an especially good procedure for the diagnosis of microscopically metastases as disease status is an important diagnostic and prognostic factor in early-stage melanoma patients. However, due to the complex lymphatic system in head and neck melanoma, a short follow-up interval is necessary in order to prevent delayed diagnosis of a nodal recurrence due to a false-negative SLN. 相似文献2.
C.G.U. Riese J.-A. Karstadt A. Schramm S. Güleryüz G. Dressel K.J. Lorenz B. Klemenz A. Sailer S. Seitz F. Wilde 《Journal of cranio-maxillo-facial surgery》2018,46(10):1748-1752
Purpose
This study investigates the possibility and sensibility of using sentinel node biopsy (SNB) during surgery for oropharyngeal carcinomas with clinically and radiographically unremarkable cervical lymph nodes.Materials and methods
A total of 36 patients who were treated for early oral and oropharyngeal carcinoma and unremarkable cervical lymph nodes were included in this study. After lymphoscintigraphy for detecting sentinel lymph nodes (SLN), the SLN were excised first. Thereafter elective neck dissection was performed. Histopathological and immunochemical examinations were used to examine the SLN and all other lymph nodes.Results
The preoperative SLN detection rate was 97.2% (35 of 36). SLN in level V were detected in four patients (11.1%). Metastases were found in 33.3% of the patients (12 of 36). All metastases were in the marked SLN. No skip metastases could be detected. A specificity of 100% and a sensitivity of 94.4% were identified for the SNB.Conclusion
The study confirms that SNB is a precise diagnostic procedure for assessing the nodal status of cervical lymph nodes. Further studies are needed to determine whether SNB without elective neck dissection for clinically and radiologically unremarkable cervical lymph nodes can become a reliable course of treatment for carcinomas of the head and neck region. 相似文献3.
V. Rempel A.F. Safi U. Drebber H.J. Nickenig J. Neugebauer J.E. Zöller M. Kreppel 《Journal of cranio-maxillo-facial surgery》2018,46(9):1659-1663
Background
This study aims at investigating the prognostic significance of lymph node ratio (LNR) in a cohort of patients with oral squamous cell carcinomas (OSCC), treated with neoadjuvant radiochemotherapy followed by radical surgery.Methods
The study included 171 treatment-naive patients with biopsy-proven primary OSCC, being reviewed retrospectively. All patients received a concomitant neoadjuvant radiochemotherapy (RCT) followed by radical surgery of the primary tumor and neck dissection based on the pretreatment staging results. The Kaplan–Meier survival analysis method was used to estimate the events of interest for overall survival (OS). Prognostic factors were identified through univariate and multivariate analysis.Results
The 5-year overall survival rate for all patients was 48 %. In univariate analysis, patient's age and data compiled from the histopathological examination as margin status, extracapsular spread, ypT, ypN, ypUICC, number of positive lymph nodes and lymph node ratio (LNR) had a statistically significant impact on overall survival. Multivariate analysis revealed an independent significant impact of patient age, ypT, margin status and LNR on OS. ypN showed no statistical significant impact on OS.Conclusion
Our results show that LNR is an important predictor for OS in patients with OSCC that were treated with neoadjuvant radiochemotherapy and radical surgery. 相似文献4.
Ali-Farid Safi Martin Kauke Andrea Grandoch Hans-Joachim Nickenig Joachim Zöller Matthias Kreppel 《Journal of cranio-maxillo-facial surgery》2018,46(6):1007-1012
Purpose
Lymph node ratio (LNR) essentially improves assessment of prognosis and therapeutic decision making for patients with oral squamous cell carcinoma, as it considers both the number of positive lymph nodes and the number of dissected lymph nodes. Mandibular infiltration by oral squamous cell carcinoma is a vital clinicopathological feature, significantly worsens prognosis. However, to the best of our knowledge, data on the influence of LNR on prognosis for patients with OSCC and mandibular infiltration are not available.Materials and methods
A retrospective chart review of 89 patients with treatment-naive oral squamous cell carcinoma and histopathologically proven mandibular infiltration (pT4a) was performed. Exclusion criteria were primarily curative intended surgery (radical tumor resection, neck dissection and segmental mandibulectomy) with negative resection margins. Exclusion criteria were neoadjuvant chemoradiotherapy, erosive infiltration of the mandible, T4b classification, perioperative death, unresectable disease, synchronous malignancy, follow-up <3 months, and inadequate information to correctly determine clinicopathological characteristics.Results
We observed a significant correlation on univariate analysis between locoregional recurrence and pathologic N classification (p = 0.004), perineural invasion (p = 0.005) and lymph node ratio (p < 0.001). On multivariate analysis, lymph node ratio (p = 0.028) was shown to be an independent indicator for locoregional recurrence.Conclusion
LNR predicted locoregional recurrence better than the conventional nodal staging system and therefore might serve as a more precise risk stratification tool. LNR >7% led to a 11.419-fold higher risk for locoregional recurrence of patients with mandibular infiltration due to OSCC. 相似文献5.
Sebastian Blatt Holger Schön Keyvan Sagheb Peer W. Kämmerer Bilal Al-Nawas Eik Schiegnitz 《Journal of cranio-maxillo-facial surgery》2018,46(2):207-212
Aim
For oral squamous cell carcinoma (OSCC), biomarkers are much in need to predict prognosis and to overcome possible resistance mechanisms to adjuvant therapies. The aim of this study was to evaluate serum level of hemoglobin, C-reactive protein (CRP) and ferritin as possible liquid biopsy to predict survival, metastasis and tumor relapse of OSCC.Material and methods
A prospective clinical study was conducted. Overall, serum levels of hemoglobin, CRP and ferritin in 82 OSCC patients and 63 controls were preoperatively investigated.Results
Patients with an anemia showed a significant lower survival than patients with no anemia preoperative. Patients with T3/T4 cancer had significant lower hemoglobin values (p = 0.002). CRP and ferritin were statistically overexpressed in late tumor stages T3/T4 (ferritin: p = 0.045, CRP: p < 0.05) compared to control. Log Rank testing indicated a statistical correlation of up regulated ferritin levels with local tumor recurrence (p = 0.012) and local lymph node metastasis (p = 0.008).Conclusion
Presented biomarker CRP, ferritin and hemoglobin may serve as a liquid biopsy for prediction of OSCC especially for larger tumor sizes, overall survival and tumor relapse and demand a more radical therapy approach. 相似文献6.
Yoldez Houcine Emna Romdhane Ahlem Blel Meriem Ksentini Raoudha Aloui Rim Lahiani Nadia Znaidi Mamia Ben Salah Soumaya Rammeh 《Journal of cranio-maxillo-facial surgery》2018,46(7):1117-1120
Purpose
Surgical biopsy examination is the gold standard for the diagnosis of lymph node lymphomas. Fine-needle aspiration cytology (FNAC) is a quick and safe method in the management of cervical lymph nodes. Its value in confirming recurrent or residual lymphoma is well established. However, its role in the primary diagnosis of lymph node lymphoma remains controversial. The aim of this study was to assess, in our experience, the reliability of FNAC in the diagnosis of cervical lymph node lymphomas.Materials and methods
This was a retrospective study carried out over a 6-year period (January 2011 to December 2016) and conducted at the Cytology Unit in our Pathology Department (Charles Nicolle Hospital, Tunisia). The measures of diagnostic accuracy of FNAC in the diagnosis of cervical lymph node lymphomas were calculated taking histopathology as the gold standard.Results
A total of 937 FNA samples were obtained from 851 patients. The diagnosis of lymphoma was obtained in 65 cases (6.9%). Cytological diagnoses of lymphoma were as follows: 28 (44%) Hodgkin lymphoma, 17 (25%) high-grade lymphoma, 15 (23%) low-grade lymphoma, and 5 (8%) “suggestive of lymphoma.” FNAC of cervical lymph nodes had a sensitivity of 95.5%, specificity of 98.7%, positive predictive value (PPV) of 97.7%, and negative predictive value (NPP) of 97.5%.Conclusion
The present study demonstrated that cytology is capable to detect nodes suspicious for the presence of lymphoma precisely, in terms of low- or high-grade lymphoma, which is a relevant and very achievable first step in the management of patients with cervical lymph node lymphoma. 相似文献7.
Ali-Farid Safi Martin Kauke Hendrik Jung Marco Timmer Jan Borggrefe Thorsten Persigehl Hans-Joachim Nickenig Max Zinser David Maintz Matthias Kreppel Joachim Zöller 《Journal of cranio-maxillo-facial surgery》2018,46(6):1013-1018
Introduction
Recent studies highlighted the prognostic superiority of lymph node volume towards the conventional N Classification. However, data on the importance of neck lymph node volume, obtained by semiautomatic segmentation of CT images, do not exist for locoregional recurrence in patients with oral squamous cell carcinoma (OSCC).Methods
Retrospective chart review of 100 patients, who were diagnosed and treated between 2006–2014. Inclusion criteria were patients with treatment-naive oral squamous cell carcinoma and primarily curative intended surgery with negative resection margins, for whom a preoperative computed tomography (CT) of the head and neck region was performed. Furthermore, comprehensive neck dissection (level I-V) due to ipsilateral lymph node metastasis was chosen as inclusion criterion. Exclusion criteria were neoadjuvant chemoradiotherapy, T4b classification, perioperative death, unresectable disease, synchronous malignancy, follow-up < 3 months and inadequate information to correctly determine clinicopathological characteristics.Results
Pathological N Classification (p = 0.001), central necrosis (p = 0.008) and lymph node volume (p < 0.001) significantly affected locoregional recurrence (p < 0.001). Multivariate analysis indicated N Classification (p = 0.06) and volume (p < 0.001) as indepedent risk factors for locoregional recurrence.Conclusion
Volumetric measurement serves as a better risk stratification tool than the conventional N Classification for OSCC. A lymph node volume of more than 6.86 cm3 goes along with a 20-fold higher risk for locoregional failure. 相似文献8.
Matthias Zirk Ali-Farid Safi Johannes Buller Hans-Joachim Nickenig Timo Dreiseidler Max Zinser Uta Drebber Joachim E. Zöller Matthias Kreppel 《Journal of cranio-maxillo-facial surgery》2018,46(2):195-200
Background
Recently, lymph node ratio (LNR) has been recognized as an important prognosticator for oral squamous cell carcinoma (OSCC). However, its relevance for the specific subsite floor of mouth (FOM) has not been investigated. This study was conducted to elucidate the prognostic significance of LNR for the subsite FOM among other prognostic factors.Methods
A retrospective study of 155 patients with FOM SCC who received primary curative resection and neck dissection was conducted. We analyzed the impact of LNR among other clinicopathologic variables on overall survival (OS) in univariate and multivariate analysis.Results
In univariate analysis, patients detected with LNR ≤ 0.07 (cutoff-point: 0.07) showed an 85% 5-year OS rate, whereas for patients with LNR > 0.07 the OS rate reached 25% after 5-years (p < 0.001). The 5-year DFS rate was 72% for patients with LNR ≤ 0.07; on the contrary, patients with LNR > 0.07 the 5-year DFS rate was 17% (p < 0.001). LNR was detected as an independent predictor of OS in multivariate analysis (p = 0.032) for the subsite FOM.Conclusion
We concluded that LNR is an important predictor of prognosis in patients with FOM SCC, LNR should be considered in the choice of adjuvant treatment for these patients. 相似文献9.
Eric A. Dik Norbertus A. Ipenburg Peter A. Kessler Robert J.J. van Es Stefan M. Willems 《Journal of cranio-maxillo-facial surgery》2018,46(6):1001-1006
Introduction
In oral squamous cell carcinoma (OSCC) the differentiation grade of the tumor is determined on the biopsy and the resection specimen. The relation between tumor grade, nodal metastasis and survival is debatable. The aims of this study were to determine the correlation between differentiation grade of the biopsy and the resection specimen. Furthermore, we wanted to correlate tumor differentiation grade with nodal stage and survival.Patients and methods
One-hundred and forty-five patients with OSCC staged as T1-2, N0 of the tongue, floor of mouth or cheek with primary resection of the tumor were examined. Biopsy and resection specimen were histologically re-assessed with regard to differentiation grade, as well as infiltrative, peri-neural and vascular invasive growth.Results
This study showed a poor correlation between differentiation grade in the incisional biopsy and the resection specimen of the same tumor. No significant relation between differentiation grade of the resection specimen and nodal involvement, as well as overall and disease-specific survival was found.Conclusion
In early OSCC the differentiation grade determined by biopsy is of little predictive value for the grading of the resection specimen. Poor differentiation grade could not be related to the presence of nodal metastasis or survival and seems not to have any prognostic value concerning outcome. Treatment planning must be related to these findings. 相似文献10.
Kai Qian Kai Guo Xiaoke Zheng Wenyu Sun Tuanqi Sun Lili Chen Ding Ma Yi Wu Qinghai Ji Zhuoying Wang 《Journal of cranio-maxillo-facial surgery》2019,47(1):47-52
Purpose
To evaluate whether elective neck dissection (END) was beneficial for cN0 patients with salivary gland carcinoma.Materials and methods
The rates of regional failure-free survival and disease-free survival were calculated using Kaplan–Meier methods and Cox models. The risk factors for occult lymph node metastasis (OLNM) in cN0 patients undergoing END was analyzed using logistic regression. A nomogram was formulated to calculate the estimated probability of OLNM.Results
Neck dissection was performed in 84 patients (43.3%). OLNM was detected in eight of the patients who underwent END. During the follow-up period, regional recurrences involving cervical lymph nodes were found in 10 patients. Cox model analysis revealed that neck dissection was not related to regional failure-free survival and disease-free survival. Logistic regression analysis revealed that older age, neural symptoms, and positive adjacent lymph nodes were associated with OLNM. A nomogram comprising age, neural symptoms, and adjacent lymph nodes was developed to predict the risk of OLNM.Conclusion
The incidence of OLNM was low in cN0 patients after detailed preoperative evaluations. There was no strong evidence supporting END as a conventional therapy in cN0 patients with salivary cancers. Our nomogram is a simple and practical instrument for strengthening the prediction of OLNM. 相似文献11.
目的 探讨前哨淋巴结活检（sentinel lymph node biopsy，SLNB）在口腔鳞状细胞癌临床应用中的可行性、准确性。方法 对31例口腔鳞状细胞癌患者术前使用核素扫描法行前哨淋巴结（sentinellymphnode，SLN）示踪，体表定位；术中γ-探测仪进一步识别SLN行前哨淋巴结活检，同时行颈淋巴清扫；术后对SLN和颈淋巴清扫的病理检查结果进行分析。结果 SLNB对全组病例颈部淋巴结转移状况评价的准确率为96．8％。灵敏度为92，3％，假阴性率为7．7％。结论 SLNB是口腔鳞状细胞癌治疗中的一项新技术，能高灵敏度的反映颈淋巴结状态，具有临床可实用性。 相似文献
12.
Lizhong Liang Haiji Luo Qifen He Yingying You Yunping Fan Jun Liang 《Journal of cranio-maxillo-facial surgery》2018,46(4):605-610
Purpose
The aim of this study is to investigate the expression of the autophagy protein p62 in oral squamous cell carcinoma (OSCC) cells before and after chemotherapy. We also detected cancer-associated fibroblasts (CAFs) in these OSCC samples to explore the roles of p62 and CAFs in chemotherapy.Materials and methods
Immunohistochemistry was used to analyze the expression of p62 and α-SMA in 26 paired OSCC samples before and after chemotherapy. The relationships between clinicopathological features, clinical outcome and the expression of these proteins were analyzed.Results
Our results indicated an increased stromal α-SMA expression after chemotherapy in OSCC samples. High p62 expression of OSCC cells closely correlated with stromal α-SMA expression after chemotherapy. Furthermore, the post-chemotherapy p62 expression was associated with the prognosis for OSCC patients.Conclusion
These results suggest that chemotherapy may increase CAFs in OSCC. High cytoplasmic p62 expression may serve as a poor prognostic marker for OSCC patients. 相似文献13.
C.M. Bowe M. Shastri A. Gulati P. Norris A. Corrigan A.W. Barrett B. Bisase 《The British journal of oral & maxillofacial surgery》2021,59(2):217-221
UK national guidelines in 2016 recommended that sentinel lymph node biopsy (SLNB) should be offered to patients with early oral squamous cell carcinoma (OSCC). We review the establishment of an OSCC SLNB service with specific consideration to resources, service implications and patient outcomes. A review of processes was performed to identify key stages in establishing the service, and subsequently a retrospective cohort study consisting of 46 consecutive patients with T1/T2 N0 OSCC was undertaken. The key stages identified were: coordinating a nuclear medicine pathway and reliable cost-appropriate pathology service, constructing a Trust business case, and gaining approval of a new interventional service policy. A median (range) of 3.3 (1-8) sentinel nodes (SLN) were removed, with 17 patients having a positive SLN. The negative predictive value of SLNB was 100%, with 12 having a SLN outside the field if elective neck dissection (END) was planned. There was a significantly increased risk of a positive SLN with increasing depth of invasion (DOI) (p=0.007) and increased diameter (p=0.036). We also identified a longer-than-ideal time to completion neck dissection and inadequate ultrasound follow up of negative SLNB patients. Establishment of a service requires careful planning. Our results were in keeping with those reported in the literature, and showed that SLNB for OSCC has a high negative predictive value and can identify at-risk SLN outside the traditional END levels, even in well-lateralised tumours. Our findings show that DOI and size of SLN were significantly associated with a positive SLN, and also identified areas requiring improvement. 相似文献
14.
老年口腔鳞癌前哨淋巴结活检的临床病理研究 总被引：1，自引：1，他引：0
目的:探讨前哨淋巴结活检(sentinel lymph node biopsy,SLNB)预测老年口腔鳞癌患者颈部淋巴结转移的价值及提高病理准确性的方法。方法:对18例临床及影像学检查阴性的老年口腔鳞癌患者,采用1%美兰示踪定位识别前哨淋巴结,随后行全颈淋巴结清扫,将SLN做连续病理切片检查。结果:18例患者中检出SLN14例,其中13例的SLN能准确预测颈部淋巴结的转移状况。结论:应用美兰能准确定位SLN,前哨淋巴结连续病理切片活检结果,能准确预测颈部淋巴结的转移状况,具有潜在的临床应用价值。 相似文献
15.
目的：探讨术前前哨淋巴结（SLN）的同位素显像（SPECT）在老年口腔鳞癌颈部隐匿转移中的诊断价值。方法：选择临床检测淋巴转移阴性的老年患者20例,肿瘤旁粘膜下注射99Tcm标记的右旋糖酐（DX）术前淋巴显像定位SLN,对SLN和非SLN采用连续病理切片行常规病理检测,对比SLN和非SLN淋巴结转移数据。结果：同位素淋巴显像法检测出17例口腔鳞癌的SLN共计36枚,平均2.3枚,SLN检测转移阳性5例,其中1例同时伴NSLN转移.未发现单独的NSLN转移。结论：同位素显像（SPECT）对前哨淋巴结（SLN）具有较高的检出率,前哨淋巴结（SLN）的检测结果可真实反映cN0期老年口腔鳞癌隐匿转移中的状况. 相似文献
16.
《Journal of cranio-maxillo-facial surgery》2020,48(3):217-222
PurposeThis study evaluated the usefulness of sentinel lymph node (SLN) biopsy with preoperative computed tomographic lymphography (CTL) and intraoperative indocyanine green (ICG) fluorescence imaging for N0 early tongue cancer.MethodsTwenty-seven patients with N0 early oral tongue cancer underwent CTL with a 128-slice multi-detector row CT scanner to detect SLN on the day before resection of primary tumor and SLN biopsy under ICG fluorescence guidance. We identified the location and number of SLNs mapped by CTL and evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. Prognosis was also evaluated.ResultsSLNs were detected by CTL in 26 of 27 patients (96.3%). The total and mean numbers of SLNs were 41 and 1.5, respectively. All SLNs enhanced by CTL could be identified intraoperatively as ICG fluorescent lymph nodes. Two SLNs were found under ICG fluorescent guidance in only one patient without SLN enhanced by CTL. Among the 27 patients, five (18.5%) had SLN with metastasis. Median follow-up was 76 months (range 44–82 months). During follow-up, three of 22 patients without SLN metastasis had occult cervical lymph node metastasis. The 5-year overall survival rate was 100%.ConclusionSLN biopsy with preoperative CTL and intraoperative ICG fluorescence imaging is a feasible and reliable procedure, without radioisotope tracers, for neck management in cases of early tongue cancer. 相似文献
17.
Julius Moratin Andreas Fuchs Carolin Zeidler Urs D.A. Müller-Richter Roman C. Brands Stefan Hartmann Alexander C. Kübler Christian Linz 《Journal of cranio-maxillo-facial surgery》2018,46(4):611-616
Introduction
Squamous cell carcinoma of the maxilla only constitutes a small fraction of Head and Neck Cancers. There is thereby a lack of information about frequent tumor staging and localization and their effect on patients' outcome. The main factors that influence longterm survival in HNSCC are the extent of the primary disease and recurrence rate, including local neck metastases.Patients and methods
In this study, clinical outcome and rates of disease recurrence in 68 surgically treated patients with maxillary SCC were evaluated in terms of primary tumor staging and localization.Results
It could be demonstrated that maxillary cancer is mostly located in the posterior region of the upper jaw (70%). The rate of neck node metastasis was 35.3%, which is equivalent to the rest of the oral cavity and supports the role of elective neck dissection for patients with clinically negative neck node status. Staging, tumor differentiation, and infiltration of lymphatic structures correlated significantly with the development of local neck node metastases (r = 0.321, p = 0.01; r = 0.348, p < 0.01; r = 0.64; p < 0.01).Conclusion
Maxillary carcinomas exhibit similar rates of locoregional disease recurrence as the rest of the oral cavity. The existence of cervical metastases even in patients with T1 tumors supports the concept of elective neck dissection in early tumors with clinically negative neck status. 相似文献18.
Paolo Cariati Almudena Cabello Serrano Jose Fernandez Solis Ildefonso Martinez Lara 《Journal of cranio-maxillo-facial surgery》2018,46(1):155-161
Purpose
The aims of this study were to evaluate the pattern of distribution of cervical metastasis in tongue cancer and to analyze the various therapeutic options available. Moreover, numerous histological features were analyzed to assess the impact of each factor on overall survival.Materials and methods
A retrospective analysis was conducted using the records of patients diagnosed with oral tongue cancer between 2004 and 2010 in the Virgen de las Nieves University Hospital (HUVN). A total of 117 patients with squamous cell carcinoma of the tongue treated with glossectomy and selective neck dissection were included in the study. The pattern of distribution of cervical metastases and numerous histological features such as T-stage, N stage, surgical margins, tumor thickness, extracapsular spread (ECS) and vascular invasion were analyzed.Results
Level IIA was the most affected, followed by level III. The rate of skip metastasis was 7,4%. T and N stage, tumor thickness, ECS, surgical margins and nerve and vascular invasion were associated with poorer outcomes in terms of overall survival (p < 0,001).Conclusion
Cervical nodal involvement represents the major prognostic factor in tongue cancer. A total of 51,2% of N+ patients presented T1 and T2 tumors in this series. We recommend performing neck dissection at the early stages in clinically N0 patients when a tumor thickness >0,4 cm is suspected. Level IV should be included in the neck dissection of clinically N0 tongue cancer. 相似文献19.
20.
Eleni Georgakopoulou Justin Stebbing Crispian Scully 《Journal of the American Dental Association (1939)》2018,149(2):100-111