Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press20310.17650/2222-1468-2016-6-2-12-16DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИRecovery surgery for extracapsular extension of squamous cell cancer metastasizing to the lymph nodes in the neck«Операция спасения» при экстракапсулярном распространении метастазов плоскоклеточного рака в лимфатические узлы шеиSikorskiyD. V.СикорскийД. В.
Russian Federation

190 Rоdionova St., Nizhniy Novgorod, 603126

603126, Нижний Новгород, ул. Родионова, 190

sikorski-d@mail.ruPodvyaznikovS. O.ПодвязниковС. О.
Russian Federation

Department of Oncology, 

2/1 Barrikadnaya St., Moscow, 125993

кафедра онкологии,

125993, Москва, ул. Баррикадная, 2 / 1

ZhelezinO. V.ЖелезинО. В.
Russian Federation

190 Rоdionova St., Nizhniy Novgorod, 603126

603126, Нижний Новгород, ул. Родионова, 190

KopeykinaM. I.КопейкинаМ. И.
Russian Federation

190 Rоdionova St., Nizhniy Novgorod, 603126

603126, Нижний Новгород, ул. Родионова, 190

ChernyavskiyA. A.ЧернявскийА. А.
Russian Federation

10/1 Minina & Pozharskogo Square, Nizhniy Novgorod, 603005

603005, Нижний Новгород, пл. Минина и Пожарского, 10 / 1

VolodinA. N.ВолодинА. Н.
Russian Federation

190 Rоdionova St., Nizhniy Novgorod, 603126

603126, Нижний Новгород, ул. Родионова, 190

Nizhniy Novgorod Regional Clinical Oncology DispensaryГБУЗ НО «Нижегородский областной клинический онкологический диспансер»Russian Medical Academy of Postgraduate Education at the Ministry of Health of RussiaГБОУ ДПО «Российская медицинская академия последипломного образования» Минздрава РоссииNizhniy Novgorod State Medical Academy at the Ministry of Health of RussiaГБОУ ВПО «Нижегородская государственная медицинская академия» Минздрава России230620166212162206201622062016Copyright ©; 2016, Sikorskiy D.V., Podvyaznikov S.O., Zhelezin O.V., Kopeykina M.I., Chernyavskiy A.A., Volodin A.N.Copyright ©; 2016, Сикорский Д.В., Подвязников С.О., Железин О.В., Копейкина М.И., Чернявский А.А., Володин А.Н.2016Sikorskiy D.V., Podvyaznikov S.O., Zhelezin O.V., Kopeykina M.I., Chernyavskiy A.A., Volodin A.N.Сикорский Д.В., Подвязников С.О., Железин О.В., Копейкина М.И., Чернявский А.А., Володин А.Н.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/203

Metastatic neck lymph nodes in massive lesion of their tissue with tumor cells are accompanied by extracapsular extension to the adjacent structures in a number of cases. The greatest problem in clinical oncology is when even extended radical neck dissection fails to completely remove tumor tissue that is macroscopically detectable after surgical resection. In this situation, there is a continued growth of tissue mass that is left on the neck. Thus, the unresectable extracapsular spread of neck lymph node metastases to the adjacent tissues reduces the duration of life in the patients and worsens its quality.

The basis for this investigation is clinical observations of patients who have been operated on at the Nizhny Novgorod Regional Clinical Oncology Dispensary (Hospital Two) in the period 2005 to 2016. Histologically, the tumors were squamous cell carcinomas. In this period, there have been 24 Crile operations (radical neck dissection) that are cytoreductive. A primary tumor has been (n = 15) or has not been (n = 9) previously excised. The extracapsular spread of metastatic lymph nodes corresponded to levels IIa, IIb, and III. Cytoreductive cervical lymphadenectomy with the pectoralis musculocutaneous flap covering an unresectable tumor for extracapsular unresectable squamous cell carcinoma metastasizing to the neck lymph nodes should be considered the operation of recovery. This type of surgery is warranted, as tumor mass reduction by eliminating the source of intoxication allows further antitumor treatment (radiotherapy or chemotherapy or their combination) that is contraindicated in patients with tumor lysis in the neck. When the cause of death is the exceedingly continued growth of an unresectable component of radio- and chemoresistant variants of tumor tissue on the neck, the covering of the component with a pectoralis major flap delays a fatal outcome in incurable patients to improve a number of quality-of-life indicators.

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