鼻旁窦癌的颈部管理与长期结局。
Management of the neck in paranasal sinus cancers and long-term outcomes.
文献信息
| PMID | 42829811 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Felat Toprak |
| 作者单位 | Department of Otorhinolaryngology, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey. |
| 期刊 | Acta oto-laryngologica |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 鼻旁窦恶性肿瘤罕见，且常于晚期才被发现。对于临床或影像学上N0的颈部，最佳管理方式仍存在争议。
目的/目标： 评估晚期鼻旁窦恶性肿瘤患者基于术前影像学发现的颈部淋巴结管理及长期肿瘤学结局。
材料与方法： 回顾性评估2014年至2020年间因T3或T4a鼻旁窦恶性肿瘤接受手术的34例患者。采用Kaplan-Meier分析估计总生存期（OS）和无病生存期（DFS），并使用log-rank检验比较生存曲线。
结果： 27例患者（79.4%）为T3期，7例（20.6%）为T4a期。8例患者（23.5%）有影像学上可疑的颈部淋巴结并接受了颈淋巴结清扫术；其中2例（25.0%）存在病理性淋巴结转移。3例患者（8.8%）发生颈部复发，14例（41.2%）出现局部或颈部复发。5年OS和DFS分别为48.6%和49.4%。T4a期疾病与较差的DFS相关（p < 0.001）。
结论与意义： 颈部淋巴结受累并不常见。我们的研究结果未提供证据支持对影像学N0患者进行常规选择性颈部治疗。T4a期疾病与较差的DFS相关。
英文摘要
BACKGROUND: Paranasal sinus malignancies are rare and frequently present at an advanced stage. The optimal management of the clinically or radiologically N0 neck remains controversial.
AIMS/OBJECTIVE: To evaluate cervical lymph node management based on preoperative radiological findings and long-term oncological outcomes in patients with advanced paranasal sinus malignancies.
MATERIAL AND METHODS: Thirty-four patients who underwent surgery for T3 or T4a paranasal sinus malignancies between 2014 and 2020 were retrospectively evaluated. Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier analysis, and survival curves were compared using the log-rank test.
RESULTS: Twenty-seven patients (79.4%) had T3 and seven (20.6%) had T4a disease. Eight patients (23.5%) had radiologically suspicious cervical lymph nodes and underwent neck dissection; two (25.0%) had pathological nodal metastasis. Cervical recurrence occurred in three patients (8.8%), and 14 (41.2%) experienced local or cervical recurrence. Five-year OS and DFS were 48.6% and 49.4%, respectively. T4a disease was associated with poorer DFS (p < 0.001).
CONCLUSIONS AND SIGNIFICANCE: Cervical nodal involvement was uncommon. Our findings do not provide evidence supporting routine elective neck treatment in radiologically N0 patients. T4a disease was associated with poorer DFS.