[The relationship between different types of lymph node metastasis and contralateral neck metastasis and their impact on prognosis].
摘要
OBJECTIVE: To study the relationship between different types of lymph node metastasis and contralateral neck metastasis and their impacts on prognosis. METHOD: Two hundred and forty-eight patients with supraglottic carcinomas and complete follow-up were analyzed retrospectively. Transparent lymph node detection and continuous sectioning methods were applied on postoperative neck specimens. RESULT: Cervical lymph node metastases were found in 115 patients and the lymph node metastatic rate was 46.4%. There were three types of lymph node metastases, 39 cases with single type, 34 with multiple type, 42 with fusion type. Contralateral metastatic rates were 5.1%, 44.1% and 61.9% in single, multiple and fusion type respectively. Contralateral metastasis was also related with tumor extension across midline and clinical N stages. The 3- and 5-year survival rates were 79.5% and 74.4% in single type, 61.8% and 41.2% in multiple type, 61.9% and 35.7% in fusion type. CONCLUSION: Bilateral neck dissections should be undertaken in multiple and fusion types of lymph node metastasis. The lymph node metastatic type should be an important criteria to judge prognosis.