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目的:为了制定恰当的颈清扫治疗方案,对cN0喉癌和下咽癌患者的淋巴结累及区域和复发率作一评价。方法:回顾性分析接受局限性颈淋巴结清除术的238例cN0患者,至少随访24个月,并对局部复发进行评估。结果:Ⅳ区的隐匿性淋巴结转移率是3.4%;其中单独转移至Ⅳ区的是1.5%。我们观察发现颈部的局部复发率是5.6%,在Ⅴ区没有发现淋巴结转移和局部复发。结论:当术中颈淋巴结冷冻切片为阴性,对cN0患者可合理性做出Ⅱ、Ⅲ区清扫术,Ⅳ区部分清扫术及对侧颈部淋巴结清扫术,得出结论:Ⅴ区颈清扫术是没有必要的,除非在Ⅴ区有明显的转移灶。
OBJECTIVE: To develop an appropriate neck dissection regimen to assess the extent of lymph node involvement and recurrence in patients with cN0 laryngeal and hypopharyngeal cancer. Methods: A retrospective analysis of 238 patients with cN0 who underwent localized cervical lymph node dissection was followed up for at least 24 months, and local recurrence was assessed. Results: The rate of occult lymph node metastasis in region Ⅳ was 3.4%. The rate of occult metastasis in region Ⅳ was 1.5%. We observed a local recurrence rate of 5.6% in the neck and no lymph node metastasis and local recurrence in the Ⅴ region. CONCLUSIONS: When the frozen sections of cervical lymph nodes are negative during surgery, it is feasible to make the resection of stage Ⅱ and Ⅲ, partial dissection of stage Ⅳ and contralateral cervical lymph node dissection in cN0 patients. The conclusion is that the Ⅴ neck dissection Is not necessary unless there is a clear metastasis in zone V.