2024-03-29T01:34:15Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:02000977
2023-04-27T02:15:00Z
453:455
471:561:562
Predicting Cervical Lymph Node Metastasis Following Endoscopic Surgery in Superficial Head and Neck Carcinoma
頭頸部表在癌における内視鏡治療後の後発頸部リンパ節転移予測因子の検討
Okabe, Ryuichi
岡部, 隆一
cervical lymph node metastasis
endoscopic resection
superficial head and neck carcinoma
classification of type B vessels
tumor thickness
新潟大学
Niigata University
博士(医学)
Background: Early detection of head and neck carcinoma (HNC) as superficial HNC (SHNC) identified using recently developed optical techniques, such as magnifying endoscopy and narrow-band imaging (NBI), in combination with endoscopic surgeries enables minimally invasive treatment with favorable outcomes for HNC. This study aimed to identify the predictive factors for the rare but important clinical issue of SHNC, namely cervical lymph node metastasis (CLNM), following endoscopic resection. Methods: Sixty-nine patients with SHNC who underwent endoscopic resection were enrolled in the study. Clinical data, preoperative endoscopic findings, pathological findings, and treatment outcomes were retrospectively reviewed. Because the pharyngeal mucosa lacks the muscularis mucosa, we measured tumor thickness in permanent pathology as an alternative to the depth of invasion. Correlations with the occurrence of CLNM were statistically examined. Results: The 5-year disease-specific survival rate was 100%. Of 69 patients, 3 (4.3%) developed CLNM. All had subepithelial but not epithelial tumors. The 0-IIa type in the macroscopic findings, type B2/B3 vessels in narrow-band imaging, tumors ≥ pathological stage T2, lymphatic invasion, positive surgical margins, and tumor thickness >1,000µm showed significant correlations with CLNM following endoscopic resection. Furthermore, the classification of type B vessels was significantly associated with tumor thickness. Conclusion: The treatment outcomes following endoscopic resection for SHNC were favorable. The risk of CLNM following endoscopic resection in SHNC can be predicted by several preoperative endoscopic and postoperative pathological findings. Among them, the classification of type B vessels, which correlated with both tumor thickness and CLNM, might be a useful predictive factor.
Frontiers in Surgery. 2022, 8, 813260.
新大博(医)第1823号
doctoral thesis
2022-09-20
application/pdf
application/pdf
乙第2265号
https://niigata-u.repo.nii.ac.jp/record/2000977/files/r4nmo1823.pdf
https://niigata-u.repo.nii.ac.jp/record/2000977/files/r4nmo1823_a.pdf
eng
https://doi.org/10.3389/fsurg.2021.813260
© 2022 Okabe, Ueki, Ohashi, Takeuchi, Hashimoto, Takahashi, Shodo, Yamazaki, Matsuyama, Umezu, Terai, Ajioka and Horii.
Creative Commons Attribution 4.0 International
open access