lymphatic cancer survival rate | The setting of the Lymphatic Nodes Servikal Squamosa on cancer of the oral cavity

The setting of the Lymphatic Nodes Servikal Squamosa on cancer of the oral cavity



The setting of the Lymphatic Nodes Servikal Squamosa on cancer of the oral cavity-the setting of the lymphatic area is a consideration in some cancers. The ability of the cancer to metastasize most commonly manifests itself through the growth of cancer in the lymph nodes. Handling through dissection of the neck is done for two reasons: removal of illness in patients with nodal involvement in the presence of clinical (therapeutic neck dissection) or a high level of suspicion about the occurrence of Metastatic servikal to justify the choice of a neck dissection (END). Some surgeons will also suggest that some patients who can be trusted should undergo END as advanced may not regularly performed. Hard palate and lips counteraction, about 30% of patients with oral cavity cancer matastasis will bring servikal. The decision to treat the neck NO based on the possibility of the involvement of nodal. Testing servikal for metastatic neck leaving a component that is critical of the testing of patients with cancer of the oral cavity. Manual palpation is recommended as a first step in the process and usually included before the biopsy to avoid inflammatory posbiopsi nodal. On most of the lymph nodes of the neck with the must with a diameter of at least 1 cm can be dipalpasi. Accuracy and confidence is low, palpation with the overall error of about 30% is obtained from several studies. Description of modalities including CT, MRI, ultrasound, and positron emission tomography (PET) has experienced an increasing important in evaluating the maintenance therapy metastatic and servikal.

A CT scan which contrast with the base of the skull to clavicle has been a description of the most common modality used to detect metastatic servikal (Figure 33-17). Specific criteria for nodal metastases, including the size of the node that is larger than 1 cm (except jugulodigastrik node, which must be greater than 1.5 cm), Central necrosis, and morphology (round replacing the oval) has increased sensitivitasnya up to 90%. Evaluation of MRI on neck has gained fame in recent years, and especially used if the main part has been being taken picture with MRI, such as cancer of the tongue. CT and MRI, for such purposes is most often used to describe the modalities in detecting the occurrence of metastases in the USA.

Characteristics of primary tumors can also be meprediksi the presence of metastasis. Spiro and his colleagues demonstrated that the depth of attack on tongue cancer is a real prediction tool of metastatic lymph nodes in tongue cancer. They found that the cancer with a depth of 2 to 8 mm attacks have higher levels significantly from lymph node metastasis compared the attack to a depth of less than 2 mm (25.7% vs. 7.5%). The depth of attack greater than 8 mm is linked with the level of 41% occurrence of metastases. Tumor thickness less than 2 mm have been linked to 13% the incidence of lymph node metastasis and 3% will eventually die of their disease, while the attacks more than 9 mm connected by 65% the incidence of lymph node metastasis and 35% whom would later die of his illness. O-charoenrat and his colleagues also demonstrated an increased risk of cancer of the tongue servikal metastasi in attack with depth greater than 5 mm, and connect it with little results at an early stage (I and II) from cancer of the tongue. Similar results were reported by Kurokawa and his colleagues, who found that the depth of the attacks more than 4 mm are associated with an increased risk of progression of metastases servikal in patients with slow cancer cells differentiate tongue squamosa in software, and reduced overall survival. This has been directing on a recommendation that although there is a lack of hadiran lymph node metastasis from Genesis, the neck should still receive treatment options (whether surgery or radiation) to the primary tumor which is thicker. Other researchers have also suggested that the attacks added depth in the production levels of the cell carcinoma squamosa. Besides the problem of depth, doctors have also seen other characteristics such as DNA aneuploidy and level histologiknya. At the time of deployment of this technology was not adopted in clinical settings in his.

Two additional modalities for evaluating the image of metastatic lymph node deserve mention. Ultrasonography and PET with fluorodeoksi glucose gain popularity at an early stage and the next stage of the patients with head and neck cancer. Although not commonly used in the USA, ultrasound has been used outside the clinic patients to evaluate oral cancer patients in Europe for some time. Ultrasound criteria for changes that endanger as nodal size and changes in ekogenisitas, Central necrosis that will lead to a hilum ekogenik, and a hipoekogenik peripheral. Its ability to enhance manual palpation of servikal Lymphadenopathy has directed penigkatan of its use in the USA. He can also help to evaluate the carotid or jugular attack. When used by an experienced expert and aspiration cytology, combined with ultrasound provides highly accurate results. Knappe and his colleagues reported a rate of sensivitasnya% and 89.2 spesifitasnya 98.1% level on 56 patients undergoing fine needle aspiration-ultra sound-controlled, at preoperasi, followed by selection or handling with neck dissection.

Lately it has become a popular PET in increased levels and continuation of the patients with carcinoma cells squamosa on head and neck. By identifying the brain regions with high glucose levels, PET scans allow doctors to identify metastatic potential on handling preoperasi (Figure 33-18). The presence of distant metastases can affect the initial treatment options. The role of PET scan in testing the metastasis does not seem constrained by the needs of at least 5 to 10 mm3 of tumour detection. Their role in handling patients with metastatic servikal and the primaries are not yet known, continues to be explored. PET is also used to test patients who have undergone chemoradiotherapy for disease relapse. This famous patients hard in testing both for extensive changes in the soft tissues. It is recommended that at least 3 months passed before getting a PET scan because the inflammation remained associated with radiation and the effects of tumorisidal which takes place after a complete radiation. He should also bear in mind that the technology requires a focus on healing cells carcinoma squamosa in a few millimeters to detect. First set distant metastasis is an invention that is slow in patients with head and neck cancer and most patients died of the disease more severe. It was felt that less than 1% of patients with head and neck cancer have disease that is not friendly. As the use of PET scans in the initial evaluation of patients with cancer of the oral cavity that spread widely, the detection of distant metastases at initial evaluation, are becoming more common. One result of the improvement in the detection of diseases that are not friendly to this is the level of migration. In other words, as well as our ability to detect an increase in diseases that are not friendly, more patients are in higher levels. This does not mean that patients are being diagnosed more slowly on the part of their disease than in the past, but in a simple diagnostic capability that we have increased. Cancer Squamosa