Elective regional lymphadenectomy for advanced auricular squamous cell carcinoma

• 作者: Chase M Heaton Steven J Wang William R Ryan
• 来源期刊: 世界耳鼻咽喉科杂志
• 学科: 医学
• 关键词: ADVANCED AURICULAR squamous cell carcinoma ELECTIVE LYMPHADENECTOMY ELECTIVE PAROTIDECTOMY ELECTIVE neck dissection Occult REGIONAL metastases
• 年，卷（期）: sjebyhkzz_2013,（1）
• 页码范围: 16-21
• 页数: 6页
• 分类号: R7

摘要

AIM To investigate the rate of occult lymph nodedisease in elective parotidectomy and neck dissectionspecimens in patients with advanced auricular cutaneoussquamous cell carcinoma （cSCC）.METHODS： At a single institution, from 2000 to 2010,17 patients with advanced auricular cSCC were consideredhigh risk for occult regional parotid and/or necknodal metastases and, thus, underwent an auriculectomyand elective regional lymphadenectomy （parotidectomyand/or neck dissection）. Indications for electiveregional lymphadenectomy were large tumor size,locally invasive tumors, post-surgical and post-radiationrecurrence, and being an immunosuppressed patient.We determined the presence of microscopic disease inthe regional （parotid and neck dissection） pathologyspecimens.RESULTS： There were 17 advanced auricular cSCCpatients analyzed for this study. Fifteen （88%） patientswere men. The average age was 69 （range： 33 to 86）.Ten （59%） patients presented with post-surgical recurrence.Five （29%） patients presented with postradiationrecurrence. Four （24%） patients presentedwith both post-surgical and post-radiation recurrence.Four （24%） patients were immunosuppressed （2（12%） were liver transplant patients, 2 （12%） werechronic lymphocytic leukemia patients, and 1 （6%） wasboth）. The subsite distribution of cSCC included helix（3, 18%）, antihelix （2, 12%）, conchal bowl （7, 41%）,tragus （2, 12%）, and postauricular sulcus （3, 18%）.Four （24%） patients presented with multifocal auricularcSCC. No patients had bilateral disease. All patientswere confirmed to have cSCC on final pathology. Thetumors were well （5, 29%）, moderately （10, 59%）, andpoorly （2, 12%） differentiated SCC. The average size ofthe cSCC tumor was 2.9 cm （range： 1.7 to 7 cm）. Twelve（70%） tumors were greater than 2 cm. Six （35%） patientsunderwent partial auriculectomy. Eleven （65%）patients underwent total auriculectomy. Eight （47%）patients underwent elective parotid