Metástases cervicais bilaterais no carcinoma epidermóide de cabeça e pescoço: tratamento cirúrgico em um ou dois tempos

• Autor(a) principal: Amar, Ali [UNIFESP]
• Data de Publicação: 2004
• Outros Autores: Rapoport, Abrão [UNIFESP], Cervantes, Onivaldo [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0034-72992004000100007; http://repositorio.unifesp.br/handle/11600/1953
• topic: metastases; lymph node; squamous cell carcinoma; metástases; linfonodo; carcinoma de células escamosas

AIM: To assess the results of treatment of bilateral neck metastases in patients with squamous cell carcinoma of upper aerodigestive tract. STUDY DESIGN: Retrospective case-series. MATERIAL AND METHODS: The charts of 855 patients with squamous cell carcinoma of mouth, oropharynx, hypopharynx and larynx who underwent ressection of primary tumor and radical neck dissection were reviewed. Ninety-six patients with histologically proven bilateral neck metastases were selected, 73 underwent bilateral radical neck dissection and 23 unilateral radical neck dissection and developed contralateral recurrence. The free disease survival and neck control rates were evaluated. RESULTS: Between 23 patients who underwent unilateral neck dissection and developed contralateral recurrence, only 18 were salvaged. The neck control after 2 years was achieved in 46% of patients. Between 73 patients who underwent bilateral neck dissection, 12 cases of neck recurrences were diagnosed and only 3 patients were salvaged. The neck control after 2 years was 77%, and the free disease survival was similar between the 2 groups, despite of the difference in neck control rates. CONCLUSION: The bilateral neck dissection in one stage was more effective to control neck disease but no difference of disease-free survival in comparison with two stage procedure was observed. Neck control was reached in most patients, but only 35% of those with bilateral metastases were free of disease after 2 years.