頭頚部癌の頸部リンパ節転移に関する臨床病理学的研究
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Cervical lymph node metastasis has a large impact on the prognosis of head and neck cancers, and it is very important to suppress cervical lymph node metastasis and primary lesion Neck dissection is performed to treat cervical lymph node metastasis, but in the head and neck region, occult cervical lymph node metastasis is a problem To clarify the mode of cervical lymph node metastasis in the head and neck cancer and to establish a treatment for cervical lymph node metastasis, the clinical and histopathological examinations of patients who underwent neck dissection at our department are reported in the present study. Subjects were 139 patients who underwent neck dissection on 149 sides at our department over a 28-year period between 1975 and 2003 From the 149 sides, a total of 1,862 lymph nodes were removed, an average of 12 5 nodes per side Of the 1,862 nodes, metastasis was confirmed in 172 nodes As for the location of metastatic lymph nodes, levels I, II and III accounted for 90% of the metastatic lymph nodes Based on histological findings at the initial visit, the incidence of metastatic lymph nodes was high for histologically malignant cancer In terms of cumulative survival, factors associated with poor prognosis included three or more metastatic lymph nodes, extranodal invasion, and metastatic lymph nodes at level III or IV. The above findings clarify the mode of metastasis to the cervical lymph nodes, and suggest the possibility that neck dissection for level V involvement can be omitted in some patients Further, as to the timing of neck dissection, there was no marked difference in prognosis between immediate neck dissection or subsequent neck dissection.
- 岩手医科大学歯学会の論文
- 2003-12-24
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