Literature DB >> 16720144

Elective neck dissection for carcinomas of the oral cavity: occult metastases, neck recurrences, and adjuvant treatment of pathologically positive necks.

Peter Zbären1, Michel Nuyens, Marco Caversaccio, Edouard Stauffer.   

Abstract

BACKGROUND: Supraomohyoid neck dissection (SOHND) is currently performed in patients with carcinoma of the oral cavity with clinically negative neck. Most investigators consider SOHND as a staging procedure.
METHODS: Records of 100 patients with cancer of the oral cavity and clinically negative neck undergoing SOHND were reviewed. The rate and significance of occult metastases are evaluated, the neck recurrences are analyzed and the indication of adjuvant radiation of pN+ necks is discussed.
RESULTS: In 34 of 1814 of analyzed lymph nodes, metastatic disease was detected as follows: 30 macrometastases and 4 micrometastases. In 13 of 34 metastases (38%), extracapsular spread was observed. Twenty of 100 patients (20%) had to be upstaged. In 9 of 87 (10%) patients without local recurrence and with a minimal follow-up of 24 months, 5 ipsilateral (4 within the dissection field) and 5 contralateral neck recurrences were observed. Regional recurrence developed in 4% and 35% of patients with pN0 and pN+ necks, respectively.
CONCLUSIONS: In 20% of patients with oral cavity tumors and pN0 neck, occult metastases were disclosed. Neck recurrences developed significantly more often in patients with pN+ than in those with pN0 necks. To evaluate the exact indication for an adjuvant treatment of patients with cN0/pN+ necks, prospective studies should be performed.

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Year:  2006        PMID: 16720144     DOI: 10.1016/j.amjsurg.2006.01.052

Source DB:  PubMed          Journal:  Am J Surg        ISSN: 0002-9610            Impact factor:   2.565


  10 in total

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2.  Elective management of cervical and parotid lymph nodes in stage N0 cutaneous squamous cell carcinoma of the head and neck: a decision analysis.

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4.  Recurrence of Lymph Node Micrometastases After Radiotherapy for Head and Neck Carcinoma: A Propensity Score-matched Study.

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6.  Discontinuous vs. in-continuity neck dissection in carcinoma of the oral cavity. Experience of two oncologic hospitals.

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7.  Preclinical Assessment of the Effectiveness of Magnetic Resonance Molecular Imaging of Extradomain-B Fibronectin for Detection and Characterization of Oral Cancer.

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9.  Contralateral Regional Recurrence in Lateralized or Paramedian Early-Stage Oral Cancer Undergoing Sentinel Lymph Node Biopsy-Comparison to a Historic Elective Neck Dissection Cohort.

Authors:  Rutger Mahieu; Inne J den Toom; Koos Boeve; Daphne Lobeek; Elisabeth Bloemena; Maarten L Donswijk; Bart de Keizer; W Martin C Klop; C René Leemans; Stefan M Willems; Robert P Takes; Max J H Witjes; Remco de Bree
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10.  Elective neck dissection versus "wait and watch" policy in tongue carcinoma.

Authors:  Satish Kumaran Pugazhendi; Lalitha Thambiah; Anuradha Venkatasetty; Vinod Thangaswamy
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  10 in total

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