颈淋巴结转移对晚期喉鳞状细胞癌生存影响

【目的】 探索颈淋巴结转移对晚期喉鳞状细胞癌患者生存率的影响。【方法】 对1990年1月-2005年12月在中山大学肿瘤防治中心住院治疗的312例晚期喉鳞状细胞癌患者资料进行回顾性分析。初诊时临床有颈淋巴结转移者(cN+)141(45.2%)例,临床无颈淋巴结转移者(cN0)171(54.8%)例、颈淋巴结转移与否及N分期对生存率影响采用Kaplan-Meier法和Log-rank检验。【结果】 初诊时141例cN+患者与171例cN0患者5年生存率分别为33.7% 和 60.5%(P < 0.001),cN1 ~ cN3期患者5年生存率分别为40.6%、33.6%、0%(P < 0.001)。初诊时cN+患者占45.2%(141/312);经治疗后,141例初诊cN+患者病理颈淋巴结转移,30例(30/171,17.5%)cN0初诊患者病理颈淋巴结转移,最终54.8 % (171/312)患者出现病理颈淋巴结转移。【结论】 有颈淋巴结转移的晚期喉鳞状细胞癌患者预后差,且N分期越晚预后越差,应积极治疗晚期喉鳞状细胞癌患者的颈部淋巴结。

Survival Impact of Cervical Metastasis in Advanced Laryngeal Squamous Cell Carcinoma

【Objective】 To explore the impact of cervical metastasis on the survival of patients with advanced laryngeal squamous cell carcinoma.【 Methods】 Between January 1990 to December 2005,312 cases of squamous cell carcinoma of the larynx hospitalized in Cancer Center,Sun Yat-sen University were reviewed retrospectively.141 patients(45.2%) had positive clinical cervical nodal disease(cN+) and 171 patients(54.8%) had negative clinical cervical nodal disease(cN0) at initial presence.Survival differences according to presence or absence of clinical cervical nodal disease and N-stage were determined with Kaplan-Meier method and the log-rank test.【Results】 The 5-year survival rates for cN+ patients and cN0 were 33.7% and 60.5%(P < 0.001).The 5-year survival rates were 40.6%,33.6%,and 0% for cN1～cN3 lesions,respectively(P < 0.001).Clinical cervical metastasis was detected in 45.2%(141/312 cases) of those individuals with advanced laryngeal squamous cell carcinoma presenting for initial clinical consultation;after therapy,those cN+ patients(141 cases) all had positive histological cervical metastasis and 30 cases(30/171,17.5%) of those cN0 individuals had positive histological cervical metastasis.Finally,54.8%(171/312) of our patients with histologically positive necks manifested disease to the cervical lymph nodes.【Conclusion】 The patients presence of cervical nodal disease associated with decrease survival rate.Besides,advanced N-stage significantly correlated with worse prognosis.The cervical lymphy node of advanced laryngeal squamous cell carcinoma should be treated aggressively.