Steffen Koerdt1, Jonas Röckl2, Niklas Rommel2, Thomas Mücke2, Klaus-Dietrich Wolff2, Marco R Kesting2. 1. Department of Oral and Maxillofacial Surgery, University of Technology Munich, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: steffen.koerdt@tum.de. 2. Department of Oral and Maxillofacial Surgery, University of Technology Munich, Ismaninger Str. 22, 81675 Munich, Germany.
Abstract
INTRODUCTION: A supraomohyoid neck dissection (SOHND) is part of the surgical management of patients with oral cancer, even in the absence of clinical or radiographic evidence of neck disease. We have investigated a standardized approach to the management of cervical lymph nodes, in patients with a primary oral cancer. A modified surgical technique has been presented and a clinical algorithm has been described and evaluated. MATERIALS AND METHODS: SOHND was performed either uni- or bi-laterally. In cases of positive nodes in levels II or III, the dissection was extended in terms of a modified radical neck dissection (MRND) and a SOHND was performed contralaterally. RESULTS: 112 patients were included. 42% had lymph node metastases in any level. Overall, lymph node metastases were found in 2.8% of all examined nodes. Most metastases (34.6%) occurred in level Ib. 12.6% were located in level IIb. No metastases could be detected in levels IV and V. No statistically significant difference could be shown with regard to T-stage, location, or co-factors as gender and age. DISCUSSION: SOHND is the gold-standard in patients with no preoperative evidence of lymph node metastases. The presented algorithm is able to facilitate dissection and histological analysis and might improve the surgical care in current treatment concepts. The extension to an MRND facilitates the identification of patients in need of adjuvant therapy.
INTRODUCTION: A supraomohyoid neck dissection (SOHND) is part of the surgical management of patients with oral cancer, even in the absence of clinical or radiographic evidence of neck disease. We have investigated a standardized approach to the management of cervical lymph nodes, in patients with a primary oral cancer. A modified surgical technique has been presented and a clinical algorithm has been described and evaluated. MATERIALS AND METHODS: SOHND was performed either uni- or bi-laterally. In cases of positive nodes in levels II or III, the dissection was extended in terms of a modified radical neck dissection (MRND) and a SOHND was performed contralaterally. RESULTS: 112 patients were included. 42% had lymph node metastases in any level. Overall, lymph node metastases were found in 2.8% of all examined nodes. Most metastases (34.6%) occurred in level Ib. 12.6% were located in level IIb. No metastases could be detected in levels IV and V. No statistically significant difference could be shown with regard to T-stage, location, or co-factors as gender and age. DISCUSSION: SOHND is the gold-standard in patients with no preoperative evidence of lymph node metastases. The presented algorithm is able to facilitate dissection and histological analysis and might improve the surgical care in current treatment concepts. The extension to an MRND facilitates the identification of patients in need of adjuvant therapy.
Authors: Jan Oliver Voss; Lea Freund; Felix Neumann; Friedrich Mrosk; Kerstin Rubarth; Kilian Kreutzer; Christian Doll; Max Heiland; Steffen Koerdt Journal: Clin Oral Investig Date: 2022-07-27 Impact factor: 3.606
Authors: Andreas Pabst; Daniel G E Thiem; Elisabeth Goetze; Alexander K Bartella; Michael T Neuhaus; Jürgen Hoffmann; Alexander-N Zeller Journal: Clin Oral Investig Date: 2021-03-29 Impact factor: 3.573
Authors: Falk Wehrhan; Maike Büttner-Herold; Luitpold Distel; Jutta Ries; Patrick Moebius; Raimund Preidl; Carol I Geppert; Friedrich W Neukam; Marco Kesting; Manuel Weber Journal: BMC Cancer Date: 2018-08-16 Impact factor: 4.430
Authors: Manuel Olmos; Jacek Glajzer; Tjark-Ole Büntemeyer; Gesche Frohwitter; Jutta Ries; Markus Eckstein; Markus Hecht; Rainer Lutz; Marco Rainer Kesting; Manuel Weber Journal: Front Oncol Date: 2021-07-21 Impact factor: 6.244