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성문상부 편평세포암종의 경부림프절 전이의 빈도와 유형

Other Titles
 Frequency and Patterns of nodal metastasis in supraglottic squamous cell carcinoma 
 최은창  ;  고윤우  ;  박헌이  ;  김상엽  ;  김창우  ;  김진영  ;  김광문 
 Korean Journal of Otolaryngology (대한이비인후과학회지), Vol.44(2) : 184-189, 2001 
Journal Title
Korean Journal of Otolaryngology(대한이비인후과학회지)
Issue Date
Supraglottic carcinoma ; Neck dissection ; Nodal metastasis
Background and Objectives: Supraglottic larynx is a well-known primary site of the head and neck cancer with frequent nodal metastasis, but pathologically confirmed data is lacking in our country. Patients and Methods: Pathologic reports of supraglottic squamous cell carcinoma were reviewed using the records of 73 patients who underwent surgery as an initial treatment at Severance Hospital between April 1992 and December 1999. Fifty-three patients had simultaneous bilateral neck dissection, while 13 had unilateral neck dissection. The average number of nodes investigated was 46.5 14.0 for the comprehensive neck dissection specimen and 29.4 10.9 for the lateral neck dissection. Results: Seventy-one percent of the patients had patholigically proven nodal metastasis at the time of diagnosis. Ninty-percent(47/52) of patients with pathologically proven metastasis had multiple lymph node metastasis. Nodal metastasis rate according to T stages was as follows ; T1 57.1%(4/7), T2 72.0%(18/25), T3 76.0%(19/25), T4 68.8%(11/16) respectively. Metastasis rate according to subsite was as follows ; 79.3% for epiglottis, 56.5% for false cord, 76.2% for aryepiglottic fold respectively. Ipsilateral and contralateral occult metastasis rate were 28.6%(8/28) and 14.3%(4/28), respectively. The percentage of contralateral occult metastasis for clinically ipsilateral node positive patient was 27.8%(10/36). 40.4%(19/47) of the patients with tumor which involved the midline had contralateral metastasis while 11.5%(3/26) for the patients with tumor were confined to one side. Conclusion: Patients with supraglottic squamous cell carcinoma need aggressive treatment of neck, because nodal metastasis is very frequent at the time of diagnosis. Elective treatment of contralateral neck may be needed for ipsilateral node positive patients. Patients who were clinically proven NO also need to take elective treatments at least for the ipsilateral side.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Moon(김광문)
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