Abstract：Objective To summarize the experience of surgical treatment for the benign and malignant carotid body tumor, and study the clinical value of lymph node removal around the tumor in the surgery.Methods A retrospective study was performed to analyze the clinical data of 106 patients with benign or malignant carotid body tumor who accepted surgery treatment in Chinese Academy of Medical Science Cancer Hospital from January 1976 to October 2013. In this study, there were 37 males and 69 female patients,aged from 7 to 67 years. Tumor in the left side of the 62 patients, 42 patients occurred in the right, on both sides in 2 patients. The 86 patients were diagnosed carotid body tumor in the preoperative. Another 20 patients were preoperative diagnosis of cervical neoplasm, looking forward to pathological diagnosis. No patients were diagnosed malignant carotid body tumor in the preoparative. Patients were divided into two groups according to whether or not removal of lymph node around the tumor, lymph node removal group(n=54) and no lymph node removal group(n=52), then followed up their survival and relapse situation. The Kaplan-Meier survival analysis was used to calculate the relapse-free survival rate and making a comparision of different groups.Results Among 106 patients in this group, 98 cases were followed up completely and 8 cases failed to be followed up(5 cases of lymph node removal and 3 cases of non-lymph node removal), the follow-up period was from 7 months to 38 years and the median follow-up was 8 years.The lymph node removal group had a 97.0% higher rate of relapse-free survival than the group without lymph node removal whose rate was 73.7%(χ2=9.938, P＜0.01).Besides,the patients who had been diagnosed benign or malignant with the rate 93.4% of relapse-free survival, which had a higher rate than the other patients who were considered benign by pathology diagnosis because no evidence to be diagnosed malignant without lymph nodes removal whose rate of relapse-free survival was 14.0%(χ2=45.054, P＜0.01).The group of lymph node removal had a lower rate(35.2%, 19/54) of nerve injury than the other group(at the rate of 55.8%, 29/52) without lymph node removal,the difference between groups was statistically significant(χ2=4.530, P＜0.05).Conclusions Removal of the lymph nodes around the tumor in surgical treatment of the carotid body tumor can help to diagnose accurately and guide treatment, then increase the rate of relapse-free survival after surgery. Furthermore, it can also help to expose the operative field and reduce the rate of nerve injury.
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Ma Heng, Wang Xiaolei, Zheng Shan, Xu Zhengang, Wang XiaoLiang, Yu Yue.. The advantage of lymph node removal in surgical treatment of the carotid body tumor. Chinese Journal of Anatomy and Clinics, 2016, 21(5): 460-464.
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