Patterns of regional spread and the value of elective neck treatment for oral mucosal melanoma
10.3760/cma.j.cn113030-20191023-00433
- VernacularTitle:口腔黏膜恶性黑色素瘤颈部淋巴结转移规律及颈部预防治疗的价值
- Author:
Shiran SUN
1
;
Xiaodong HUANG
;
Ye ZHANG
;
Shiping ZHANG
;
Kai WANG
;
Yuan QU
;
Runye WU
;
Qingfeng LIU
;
Xuesong CHEN
;
Jianping XIAO
;
Jingwei LUO
;
Guozhen XU
;
Li GAO
;
Junlin YI
Author Information
1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- From:
Chinese Journal of Radiation Oncology
2020;29(10):837-841
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the patterns of regional lymphatic spread and the value of elective neck treatment (ENT) in oral mucosal melanoma (OMM).Methods:In this retrospective analysis, 61 OMM patients with no distant metastasis treated in Cancer Hospital of Chinese Academy of Medical Sciences between 1984 and 2016 were recruitred. The regional lymph node distribution of cN+ disease, the value of ENT in cN 0 disease, the failure patterns and prognostic factors were retrospectively analyzed. Results:Overall, 55.7% of the patients were clinical/pathological cN+ . The most frequently involved locations were the level Ⅰ b (76%), followed by level Ⅱ and level Ⅲ. For cN 0 patients, the 5-year regional failure-free survival rate was 91.7% in patients who received at least ipsilateral level Ⅰ b-Ⅲ ENT and 52.4% in patients who did not receive at least ipsilateral level Ⅰ b-Ⅲ ENT ( P=0.036). The regional failure rate was 6% for patients treated with at least ipsilateral leve Ⅰ b-Ⅲ ENT, while in their counterparts who did not receive at least ipsilateral level Ⅰ b-Ⅲ ENT was 46%( P=0.035). For the regional failure pattern, the most frequently failure sites were level Ⅰ b (93%), level Ⅱ(50%) and level Ⅲ(36%). Conclusions:The cervical lymph node metastasis rate is relatively high in OMM patients. The pathway of regional LN spread follows a regular pattern. The most frequently involved regions for clinical/pathological cN+ and regional failure are both level Ⅰ b-Ⅲ. Elective treatment including at least ipsilateral level Ⅰ b-Ⅲ ENT should be recommended for OMM patients with cN 0.
