口腔癌の頸部リンパ節転移に関する臨床的, 病理組織学的研究

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Between 1981 and 1988, 148 total radical neck dissections (TND) were performed at the Department of Second Oral and Maxillofacial Surgery in Tokyo Medical and Dental University Hospital for initial patients with squamous cell carcinoma of the oral cavity and adjacent region. Tongue cancer patients had metastatic lymph nodes most frequently in the upper deep cervical region, lower gingiva had metastases in the submandibular region, floor of the mouth had metastases in the upper deep cervical region and in the submandibular region, and upper jaw had metastases in the upper deep cervical region and contra lateral sites. In this study of 148 determinate patients, the control rate was 65% when lymph nodes were histologically negative, 48.6% when one lymph node was positive, 43.5% when two lymph nodes were positive, 54.5% when three lymph nodes were positive, and 5.6% when four or more nodes were positive. Control rate was 65.4% for patients with lymph node involvement confined to the Level 1, 29% for patients with lymph node involvement confined to the Level 2, 33.3% for patients with spread of carcinoma to nodes in the Level 3, and 0% for patients with spread of carcinoma in the Level 4. In histopathological findings in primary region, patients with mode of invasion of 4C, 4D resulted in poor prognosis, while in metastatic cervical region patients with mode of invasion of 4D were many and showed poor prognosis. On the patterns of nodal involvement, the patients of entire node-metastatic type (Grade-D) and diffuse node-metastatic type (Grade-E) had poor prognosis. On the patterns of extranodal spread, the patients of extranodal invasion had poor prognosis. On the histological differentiation in the primary and cervical region, the patients of Grade 3 resulted in poor prognosis.

口腔癌の頸部リンパ節転移に関する臨床的, 病理組織学的研究

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