Şenol ÇOMOĞLU, Ece ÇOMOĞLU, Necati ENVER, Eren YILMAZ, Mehmet ÇELİK, Beldan POLAT, Murat ULUSAN, İsmet ASLAN, Kemal DEĞER

Paratrakeal lenf nodu diseksiyonu hangi hastalarda uygulanmalıdır?

Amaç: Bu çalışmada paratrakeal lenf nodu PTLN metastazının ileri evre larengeal ve hipofarenks kanseri hastalarında sağkalıma etkisi değerlendirildi.Hastalar ve Yöntemler: Mayıs 1995 - Haziran 2008 tarihleri arasında ameliyat olan ileri evre larengeal ve hipofarengeal kanserli hastaların tıbbi kayıtları değerlendirildi ve PTLN metastazı olan hastaların 78’i 63 erkek, 15 kadın; ort. yaş 55±11.3 yıl; dağılım 25-76 yıl çalışmaya dahil edildi. Ortalama izlem süresi 23 aydı. Elli üç hasta primer larenks kanseri ve kalan 25 hasta primer hipofarengeal kanseri idi.Bulgular: Paratrakeal lenf nodu metastazı 53 hastanın sekizinde %15 larenks kanseri ile, 14 hastanın altısında %42 postkrikoid kanseri ile, ve yedi hastanın birinde %14 ise yutak arka duvar kanseri ile tespit edildi. Paratrakeal lenf nodu metastazı, hipofarenksin piriform sinüsünden gelişen kanserli hastalarda tespit edilmedi n=4 . Paratrakeal lenf nodu metastazı 11’inde ekstranodal yayılması ENS olan toplam 15 hastada saptandı. Çoklu analizler ENS varlığının genel sağkalım üzerinde en etkili prognostik faktör olduğunu gösterdi p

Anahtar Kelimeler:

Baş ve boyun kanseri, hipofarenks, larenks, paratrakeal lenf nodu metastazı, prognoz, total larenjektomi

Paratracheal lymph node dissection, in which patients should it be performed?

Objectives: This study aims to evaluate the effect of paratracheal lymph node PTLN metastasis on survival in patients with advanced laryngeal and hypopharyngeal cancer. Patients and Methods: Medical records of advanced laryngeal and hypopharyngeal cancers who underwent surgery between May 1995 and June 2008 were assessed and 78 of the patients 63 males, 15 females; mean age 55±11.3 years; range 25 to 76 years who has PTLN metastasis were included in this study. The mean follow-up period was 23 months. Fifty-three patients had primary laryngeal cancer, and the remaining 25 patients had primary hypopharyngeal cancer. Results: Paratracheal lymph node metastasis was detected in eight 15% of 53 patients with laryngeal carcinoma, six 42% of 14 patients with postcricoid carcinoma, and one 14% of seven patients with posterior pharyngeal wall carcinoma. Paratracheal lymph node metastasis was not detected in patients with pyriform sinus carcinoma n=4 . Paratracheal lymph node metastasis was detected in a total of 15 patients, of whom 11 had extranodal spread ENS . Multivariate analysis showed that the presence of ENS was the most effective prognostic factor on the overall survival p

Keywords:

Head and neck cancer, hypopharynx, larynx, paratracheal lymph node metastasis, prognosis, total laryngectomy,

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