Critical assessment of supraomohyoid neck dissection

Conservative Neck Dissection in Oral Cancer Patients: a 5 Year Retrospective Study in Malaysia

“…The performance of a node clearing procedure, even when the neck is clinically negative, has radically altered the incidence of neck failure from recurrent disease (5.7% in this series). Our incidence of relapse in the negative operated neck is low compared to other studies, (Spiro et al, 1988;Francheschi et al, 1993;Hughes et al, 1993) but our findings emphasise the importance of including Level IV in neck dissections for all tumours involving oral cavity even when the neck is clinically negative.…”

Definitive Radiotherapy for Carcinoma of the Oral Tongue

“…Elective radical neck dissection for patients with squamous carcinoma of oral cavity revealed occult nodal metastases in 34% of NO patients, and only 3% involved level IV nodes (20). Most authors have suggested that modified neck dissection, which is associated with less morbidity, is adequate in clinically node-negative cases (12,13,20,(25)(26)(27).…”

“…The local control rate of T3-4 tumour treated by external irradiation alone is poor (Table 3) and it is unlikely that an increase of the dose could improve the results dramatically (7). T h e best treatment for these extensive tumours is probably glossectomy and neck dissection (1) with added postoperative irradiation if there is evidence of multiple node involvement or extracapsular spread (1,12,13,25,27,31). If neoadjuvant or adjuvant chemotherapy (such as 5-FU + cisplatin) can improve the result in these cases is still unknown but a t present tested in several on-going randomised multicentre studies.…”

Neck dissection alternatives

“…This strategy is however questionable. Spiro et al reported a failure rate of 29% in N+ necks treated with supraomohyoid dissection in spite of postoperative radiotherapy (Spiro et al, 1988). Tiwari, in a review of 44 supraomohyoid dissections in 31 patients with N+ necks reported that 3 patients (10%) died of disease within two years in spite of postoperative radiotherapy (Steiner and Hommerich, 1993).…”