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Sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck.

头颈部高危皮肤鳞状细胞癌的前哨淋巴结活检。

  • 影响因子:2.32
  • DOI:10.1002/lary.27881
  • 作者列表:"Wu MP","Sethi RKV","Emerick KS
  • 发表时间:2020-01-01
Abstract

OBJECTIVES/HYPOTHESIS:To describe outcomes of a single institution experience with sentinel lymph node biopsy (SLNB) for high-risk cutaneous squamous cell carcinoma of the head and neck. STUDY DESIGN:Retrospective case series. METHODS:Chart review was performed for patients who presented with clinically node negative cutaneous squamous cell carcinoma of the head and neck between December 2007 and May 2018. Patients who met high-risk criteria underwent SLNB and excision, with or without adjuvant therapy. Patients who underwent prior neck dissection were excluded. The main outcomes were SLNB result, lymph node spread, recurrence-free survival, disease-specific survival, and overall survival. RESULTS:Eighty-three patients underwent successful SLNB, and one patient underwent selective neck dissection for intraoperatively identified occult lymph node metastasis. Five patients (6%) had a sentinel node positive for tumor, of whom 4/5 received further treatment (neck dissection, radiation, and/or systemic therapy) with no further recurrence at the time of last follow-up. SLNB had a negative predictive value of 95% to 100%. Recurrent tumor at presentation, tumor arising from an area of chronic inflammation, and immunosuppression were significantly associated with increased risk of subsequent recurrence, with a mean follow-up of 19.9 months. CONCLUSIONS:SLNB can be used to identify regional lymph node metastases in cutaneous squamous cell carcinoma of the head and neck with a high negative predictive value (95%-100%). Factors associated with recurrence were tumor being locally recurrent at presentation, arising from an area of chronic inflammation, and immunosuppression. LEVEL OF EVIDENCE:4 Laryngoscope, 130:108-114, 2020.

摘要

目的/假设: 描述单个机构经验前哨淋巴结活检 (SLNB) 治疗头颈部高危皮肤鳞状细胞癌的结局。 研究设计: 回顾性病例系列。 方法: 对 2007 年 12 月至 2018 年 5 月间临床淋巴结阴性的头颈部皮肤鳞状细胞癌患者进行图表回顾。符合高危标准的患者接受SLNB和切除,伴或不伴辅助治疗。既往接受过颈清扫术的患者被排除在外。主要结局为SLNB结果、淋巴结扩散、无复发生存率、疾病特异性生存率和总生存率。 结果: 83 例患者成功行SLNB,1 例患者因术中发现隐匿性淋巴结转移行选择性颈淋巴结清扫术。5 例患者 (6%) 肿瘤前哨淋巴结阳性,其中 4/5 接受进一步治疗 (颈淋巴结清扫术、放疗和/或全身治疗) 末次随访时不再复发。SLNB的阴性预测值为 95% ~ 100%。就诊时复发的肿瘤、来自慢性炎症区域的肿瘤和免疫抑制与随后复发的风险增加显著相关,平均随访 19.9 个月。 结论: SLNB可用于识别头颈部皮肤鳞状细胞癌的区域淋巴结转移,阴性预测值高 (95%-100%)。与复发相关的因素是肿瘤在就诊时局部复发,由慢性炎症区域引起,以及免疫抑制。 证据等级: 4 喉镜,130:108-11-4,2020.

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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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