肩胛舌骨上颈清扫术对cN0口腔癌患者颈部复发影响的Meta分析

目的:评价肩胛舌骨上颈清扫术对cN0口腔癌患者颈部转移及复发的影响。方法:评价国内外1985～2004年公开发表的关于肩胛舌骨上颈清扫术与根治性颈淋巴清扫术对cN0口腔癌患者颈部转移及复发影响的对照研究,研究组接受肩胛舌骨上颈清扫术,对照组为根治性颈淋巴清扫术,结局变量为研究组与对照组颈部区域转移及复发率,应用RevMan4.2.2进行Meta分析。结果:肩胛舌骨上颈清扫组的转移及复发优势比OR=1.34,95%置信区间0.74,2.43],表明肩胛舌骨上颈清扫组与根治性颈清扫组比较,对cN0口腔癌患者术后颈部转移及复发影响的差异无统计学意义。结论:对于cN0口腔癌患者的颈部淋巴结处理,肩胛舌骨上颈淋巴清扫术与根治性颈淋巴清扫术的治疗效果一样,无显著差异。但由于某些偏倚因素可能影响结果,此结论仅供参考,尚需待新研究出现时予以再次论证。

The effectiveness of supraomohyoid neck dissection on patients with carcinoma of the oral cavity and clinically negative cervical lymph nodes: Meta-analysis

PURPOSE: To evaluate the effectiveness of supraomohyoid neck dissection on patients with carcinoma of oral cavity and clinically negative cervical lymph nodes. METHODS: The relative literatures published from 1985 to 2004 were searched and assessed, in which the effectiveness of supraomohyoid neck dissection and radical neck dissection on patients with carcinoma of the oral cavity and clinically negative cervical lymph nodes was compared. Supraomohyoid neck dissection was performed in the study group and radical neck dissection was performed in the control group. An analysis software of RevMan4.2.2 was used for statistical integration of the data. RESULTS: Meta- analysis demonstrated that the odds ratio for neck recurrence of the supraomohyoid neck dissection group compared to radical neck dissection group was 1.34, with a 95% confidence interval 0.74, 2.43. The result was statistically insignificant. CONCLUSION: Supraomohyoid neck dissection is as efficacious as radical neck dissection for treatment of patients with carcinoma of the oral cavity and clinically negative cervical lymph nodes. However, because some biases might alter the results of Meta analysis, it should be further explored when new eligible study appears.