在早期的HPV相关的舌底侧面癌症中,隐藏的逆侧瘤瘤的风险
Tyler R Halle1, Austin C Cao2, Anusha G Naik2
1Department of Otolaryngology, Emory University, Atlanta, Georgia, USA.
Head & neck
|December 10, 2025
概括
隐性逆侧淋巴结转移的风险在手术治疗的早期HPV相关的舌底口腔癌中较低. 因此,在这些患者中,可以考虑放弃逆侧部治疗.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术瘤学手术瘤学
- 头部和部癌症研究研究
背景情况:
- 在手术治疗的舌头底部与HPV相关的口腔状细胞癌 (OPSCC) 早期阶段对逆侧部的管理具有争议.
- 目前的做法通常涉及基于OPSCC的历史数据的逆侧部治疗,尽管对HPV+BOT OPSCC的证据有限.
研究的目的:
- 为了确定与HPV相关的早期BOT OPSCC接受初级手术的患者隐藏的逆侧宫淋巴结转移的发生率.
- 为了比较接受和没有接受逆侧部治疗的患者之间的生存率和复发率.
主要方法:
- 对AJCC第七版pT1-2,pN0-1HPV+BOT OPSCC的106名患者的回顾性图表审查.
- 患者接受过口腔横向机器人BOT切除和 ipsilateral 部剖析,并接受辅助治疗.
- 评估了隐藏的逆侧结节转移的发生率,并根据逆侧部治疗状态比较了生存结果.
主要成果:
- 在106名患者中,46名 (43.3%) 没有接受逆侧部治疗,29名 (27.4%) 仅接受放射治疗,31名 (29.2%) 接受了选择性逆侧部解剖 (没有发现隐性转移).
- 在接受和不接受逆侧部治疗的患者之间,没有观察到总体存活率 (HR:0.95) 或无病存活率 (HR:1.43) 的显著差异.
- 隐藏的逆侧转移的发病率在这个队列中很低.
结论:
- 隐藏的 contralateral 宫淋巴结转移的风险在早期的HPV相关的BOT OPSCC治疗初级手术中较低.
- 这些发现表明,放弃逆侧部治疗可能是选择患者的可行选择.
- 需要进一步考虑对抗侧部管理的缓解升级策略.
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