Elective radical neck dissection in epidermoid cancer of the head and neck. A retrospective analysis of 853 cases of mouth, pharynx, and larynx cancer

Khafif, Rene A.; Gelbfish, Gary A.; Tepper, Patrick G.; Attie, Joseph N.

doi:10.1002/1097-0142(19910101)67:1<67::aid-cncr2820670113>3.0.co;2-a

Cited by 68 publications

(28 citation statements)

References 17 publications

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“…The incidence of occult disease in the lymph nodes after initial treatment ranges from 13% to 33% and 27%–53% in Stage I and II, respectively. [231011121314] The rate of occult metastases in regional neck nodes in our study is 33%. Therefore, strengthening the fact that clinical palpation is grossly inadequate for evaluation of N0 neck in oral SCC.…”

Section: Discussionmentioning

confidence: 54%

Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases

Hakeem

Pradhan

Kannan

et al. 2016

Ann Maxillofac Surg

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Objective:To analyze various demographic, clinical, and histopathologic factors in T1-2 N0 squamous cell carcinoma (SCC) of the oral tongue to define a high-risk group for regional recurrence that will benefit from elective neck dissection.Materials and Methods:Retrospective outcome analysis of a patient cohort without palpable or ultrasound (USG) detectable nodal metastases undergoing per oral wide glossectomy for T1-2 N0 SCC of oral tongue. Patients were followed up using palpation and serial USG neck and fine-needle aspiration cytology.Results:Of the 176 patients, 69 (39%) showed recurrence during follow-up. Fifty-eight cases developed regional neck node metastases, i.e., overall regional node recurrence rate of 33%. Fifty-three (91%) with regional neck node metastases were salvaged successfully with further treatment. In 110 cases with tumor thickness more than 5 mm, 39% cases developed regional neck node metastases. This association was significant with P = 0.0402. Among 44 cases with perineural invasion, 54% developed regional neck node metastases. Similarly in 39 cases with lymphovascular invasion, 61% developed regional neck node metastases. Association of both of these parameters with the development of regional neck node metastases was significant.Conclusion:We recommend prophylactic selective neck dissection in early stage SCC of oral tongue, especially with depth of invasion more than 5 mm, perineural and lymphovascular invasion.

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Section: Discussionmentioning

confidence: 54%

Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases

Hakeem

Pradhan

Kannan

et al. 2016

Ann Maxillofac Surg

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“…Management of the neck with observation requires careful follow up with highly reliable imaging [75]. Some studies have reported a higher survival rate with observation than with elective neck dissection [74,76,77].…”

Section: Elective Neck Management Versus Observationmentioning

confidence: 99%

Metastasis of squamous cell carcinoma of the oral tongue

Sano

Myers

2007

Cancer Metastasis Rev

320

281

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Squamous cell carcinoma of the oral tongue (SCCOT) is one of the most prevalent tumors of the head and neck region. Despite advances in treatment, the survival of patients with SCCOT has not significantly improved over the past several decades. Most frequently, treatment failure takes the form of local and regional recurrences, but as disease control in these areas improves, SCCOT treatment failures are occurring more often as distant metastasis. The presence of cervical lymph node metastasis is the most reliable adverse prognostic factor in patients with SCCOT, and extracapsular spread (ECS) of cervical lymph nodes metastasis is a particularly reliable predictor of regional and distant recurrence and death from disease. Decisions regarding the elective and therapeutic management of cervical lymph node metastases are made mainly on clinical grounds as we cannot always predict cervical lymph node metastasis from the size and extent of invasion of the primary tumors. Therefore, the treatment of these metastases in the management of SCCOT remains controversial. The promise of basing treatment decisions on biomarkers has yet to be fully realized because of our poor understanding of the mechanisms of regional and distant metastases of SCCOT. Here we summarize the current status of investigations of SCCOT metastases and the potential of these studies to have a positive impact on the clinical management of SCCOT in the future.

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“…In the literature, the reported salvage rate varies from as low as 27% to 82% (Average, 50%) after a regional recurrence (Table 6). [3][4][5][6][7][8][9][10][11] In this study we found a salvage rate of 100%, although our followup period is still limited.…”

Section: Discussionmentioning

confidence: 68%

“…[3][4][5][6][7][8][9][10][11] (Table 6). In all these studies, in which only palpation is used to initially stage the neck, the recurrence rate in the neck is between 24% and 57% (Mean 32%) ( Table 6).…”

Section: Discussionmentioning

confidence: 99%

Role of Prophylactic Supraomohyoid Neck Dissection v/S Usg Along With Usg Fnac in Management of Clinically T1 T2 N0 Squamous Cell Carcinoma of Buccal Mucosa

Mittal¹,

Agrawal²,

Agrawal³

et al. 2016

jemds

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OBJECTIVESTo address issues like role of SND in clinically negative neck, role of ultrasound and ultrasound-guided FNAC in staging of the neck and followup. STUDY DESIGNA randomized prospective study. SETTINGMahavir Cancer Sansthan, Patna. METHODS50 patients with carcinoma of the buccal mucosa with clinically negative neck (cT1T2N0) during May 2009 to May 2011 were included in study, after obtaining well-informed written consent. Patients were examined with real time scanner with probe heads of 7.5 MHz frequency transducer. The most suspicious lymph nodes were aspirated. If positive they were randomized to neck dissection arm. Patients were then randomized to observation arm and neck dissection arm. In neck dissection arm, who have not met most suspicious lymph node criteria have undergone SND (I-III) and who were positive on FNAC have undergone MRND II (I-V). Correlation of clinicopathological variables with lymph node status was done. Patients were followed till printing of this poster. Followup visits were performed at 4-8 weeks interval. Apart from routine examination, USG was done in all patients in observation arm. For regional recurrence, MRND II was done. Data was analysed with SSPS 16.0 software windows. RESULTSA wait-and-see policy using USG and USG-FNAC has 8% recurrence rates with 100% salvage rates. CONCLUSIONProphylactic supraomohyoid neck dissection (Level I-III) is now an acceptable method of elective neck dissection in T1-T2 cancer of buccal mucosa with clinically N0 neck. A wait-and-see policy of the N0 neck after transoral tumour excision only seems feasible if a strict and accurate follow-up regimen can be provided. KEYWORDSNeck Dissection, USG. HOW TO CITE THIS ARTICLE:Mittal M, Agrawal G, Agrawal A, et al. Role of prophylactic supraomohyoid neck dissection v/s USG along with USG FNAC in management of clinically T1 T2 N0 squamous cell carcinoma of buccal mucosa.

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Elective radical neck dissection in epidermoid cancer of the head and neck. A retrospective analysis of 853 cases of mouth, pharynx, and larynx cancer

Cited by 68 publications

References 17 publications

Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases

Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases

Metastasis of squamous cell carcinoma of the oral tongue

Role of Prophylactic Supraomohyoid Neck Dissection v/S Usg Along With Usg Fnac in Management of Clinically T1 T2 N0 Squamous Cell Carcinoma of Buccal Mucosa

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