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舌癌颈淋巴结转移的处理
引用本文:吴跃煌,唐平章.舌癌颈淋巴结转移的处理[J].中国耳鼻咽喉头颈外科,1997(2).
作者姓名:吴跃煌  唐平章
作者单位:中国协和医科大学中国医学科学院肿瘤医院头颈外科!100021
摘    要:选择性颈清扫在舌癌颈部的处理是目前的流行趋势,对于提高舌癌患者生存率的意义是明确的,为探讨临床颈淋巴结阴性(cN0)的病人是否一概需作选择性颈清扫,本文回顾我院1970年~1990年期间外科收治的160例舌活动部鳞状细胞癌病人,分析其颈淋巴结的转移、处理及其转归,结果发现143例颈清扫组中cN087例,术后病理阳性(pN+)为19例(21.8%);放疗能降低颈部复发率;对于30例T1N0选择性预清扫3年无瘤生存23例(76.7%)与观察15例中存活10例(66.7%)比较无统计学差异。作者认为对于某些早期cN0病人可以不行颈部清扫,不影响其生存率而提高生活质量。

关 键 词:舌肿瘤  癌.鳞状细胞  淋巴转移

Management of neck lymph node on patients with oral tongue cancer
Wu Yuehuang, Tang Pingzhang.Management of neck lymph node on patients with oral tongue cancer[J].Chinese Archives of Otolaryngology-Head and Neck Surgery,1997(2).
Authors:Wu Yuehuang  Tang Pingzhang
Abstract:Between 1970 and 1990, 160 patients with squamous cell carcinoma of the oral tongue were surgically treated in our hospital. There were 98 males and 62 females ranging in age from 28 to 78 years. The TNM stage was T1N0M0 in 45, T1N1M0 in 9,T2N0M0 in 44, T2N1M0 in 21, T2N2M0 in 3, T3N0M0 in 8, T3N1M0 in 11, T3N2M0 in 3,T4N0M0 in 5, T3N1M0 in 9, T4N2M0 in 2, total N0 in 102 (63. 8% ), N+ in 58 (36. 3%).For the group of elective neck dissection in T1N0 stage, the neck nodal recurrence-free rate was 10. 0% (3/30), and 3 -year tumor-free survival rate was 76. 7% (23/30).For the control group (no neck dissection), the neck nodal recurrence-free rate was 13. 3% (2/15 ), 3 - year tumor - free survival rate was 66. 7% (10/15 ). Our result showed that the survival rate did not differ significantly in groups of elective dissection and no dissection. We believe that observation of patients with early and small tumor (N0), without per forming neck dissection, does not influence survival rate, on the contrary, the life quality is improved.
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