頸部淋巴廓清術在口腔癌的應用

李晏廷 ； 戴世光

《臨床醫學月刊》 91卷1期 (2023/01) Pp. 21-26

https://doi.org/10.6666/ClinMed.202301_91(1).0005

摘要

口腔癌的首選治療是手術。即便是早期T1-2口腔癌，發生頸部淋巴轉移的機率也可高達15－40%。頸部淋巴轉移是影響頭頸癌病人預後最重要的因素。因此，頸部淋巴廓清術是口腔癌治療中非常重要的環節。此文章整理了頸部淋巴廓清術應用在口腔癌的歷史背景、分類系統、適應症、及其他治療重點。

關鍵字

口腔癌（oral cavity cancer） ； 根除性頸部淋巴廓清術（radical neck dissection） ； 選擇性頸部淋巴廓清術（selective neck dissection）

參考文獻

El-Naaj IA et al. Incidence of oral cancer occult metastasis and survival of T1-T2N0 oral cancer patients. J Oral Maxillofac Surg 2011;69:2674-9.

Robbins KT et al. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 2002;128:751-8

Lindberg R. Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 1972;29:1446.

Shah JP et al. The patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity. Cancer 1990;66:109-13.

Byers RM, Weber RS, Andrews T, et al. Frequency and therapeutic implications of ‘‘skip metastases’’in the neck from squamous carcinoma of the oral tongue. Head Neck 1997;19:14-9.