口腔へん平上皮癌一次症例に対する頚部郭清の検討

Abstract

To evaluate neck dissection as an initial treatment for the control of neck metastasis, 141 patients with squamous cell carcinoma of the oral cavity who underwent neck dissection were examined.Eleven (31.4%) of 35 patients who underwent elective dissection had histologically involved nodes, and 60 (56.6%) of 106 patients who underwent therapeutic dissection also had histological evidence of involved nodes. Thus, there were 46 (32.6%) false-positive cases, 11 (7.8%) false-negative cases, and the rate of correct diagnosis for neck metastasis was 59.6%. The five-year cumulative survival for patients without neck metastasis was 85.7%, and the presence of involved nodes reduced the survival rate to 60.4%. Although there was no significant difference in survival rate among patients treated by radical neck dissection (RND), modified RND (mRND), and suprahyoid neck dissection (SHND), patients treated by SHND had a significantly higher incidence of recurrence in the ipsilateral neck than did those treated by RND/mRND. We also found a high prevalence of neck metastases in levels I-III for SCCs of the oral cavity.