早期舌癌における後発リンパ節転移の検討

Evaluation of late cervical lymph node metastasis with early tongue carcinoma

Ⅰ　はじめに

　早期舌癌（cT1-2N0M0）は5年生存率が80～90％以上と報告されている。しかし約20～50％の症例に後発リンパ節転移を認め予後に影響しているとの報告が多い^1～5）。今回早期舌癌における治療成績と後発リンパ節転移について検討したので文献的考察を加えて報告する。

　Early tongue carcinoma is a highly curable cancer but late lymph node metastasis occurs in 30-50％ of cases.

　Twenty-three early tongue carcinoma（Stage Ⅰ,Ⅱ）were enucliated surgically during nine years between 1999 and 2008 in our department. By a retrospective analysis of those cases,the risk factors of late cervical metastasis were assessed. Late cervical metastasis occurred in 30.4％（7/23 cases）of the patients. Lymphatic invasion showed a statistically significant difference as an influence factor in the late cervical metastasis. Depth of tumor showed no clear statistical difference but the possibility of late cervical metastasis rose when the depth of the tumor becam 4 mm or more. The salvage rate of the late cervical metastasis was 85.7％. Earlier detection and treatment of late cervical metastasis improved the prognosis.