임상적 N0 경부에서 예방적 경부청소술의 경험

Abstract

Background and Objectives：The status of cervical lymph node is a great influence to the prognosis of patient with head and neck cancer. There has been a great controversies on the treatment of clinical N0 neck. The purpose of this study is to analyze the outcomes of the elective neck dissection in clinical N0 neck of various sites of primary lesion. Materials and Methods：The authors analyzed the outcomes of elective neck dissection by retrospective study with review of records of 38 head and neck cancer patients (56 sites) who had clinically N0 neck. Results：The overall rate of occult neck metastasis was 31.6%. Occult neck metastasis rates according to primary sites were 37.5% (supraglottic larynx), 25.0% (glottis), 25.0% (hypopharynx) and 20.0% (tongue) and according to T stage were 50.0% (T1), 13.3% (T2), 57.1% (T3) and 0% (T4). Four cases had nodal recurrence (1 out of 4 had occult neck metastasis) after elective neck dissections and there were no significant postoperative complications. Conclusion：Due to relatively high overall occult neck metastasis rate, and no significant postoperative complications, the elective neck dissection should be considered against potential possibility of occult neck metastasis in the primary sites and extent of head and neck cancers.