Floor of Mouth Carcinoma: The Management of the Clinically Negative Neck

McGuirt, W. Frederick; Johnson, Jonas T.; Myers, Eugene N.; Rothfield, Robert E.; Wagner, Robin L.

doi:10.1001/archotol.1995.01890030020004

Cited by 129 publications

(101 citation statements)

References 20 publications

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“…END not only provides more accurate staging, it also provides objective criteria to decide when to give adjuvant therapies, such as number/levels of cervical lymph nodes involved and the presence of extracapsular spread of tumor. However, upon END and pathologic analysis of neck dissections, only 25% to 30% of clinically negative necks are found to harbor pathologic evidence of disease (10)(11)(12), and 15% of clinically positive necks are in fact tumor negative (6,13). Consequently, lymphadenectomy may represent overtreatment of almost 50% of patients.…”

Section: Introductionmentioning

confidence: 99%

Molecular Staging of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck

Ferris

Raja³

et al. 2005

Cancer Research

101

119

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Clinical staging of cervical lymph nodes from patients with squamous cell carcinoma of the head and neck (SCCHN) has only 50% accuracy compared with definitive pathologic assessment. Consequently, both clinically positive and clinically negative patients frequently undergo neck dissections that may not be necessary. To address this potential overtreatment, sentinel lymph node (SLN) biopsy is currently being evaluated to provide better staging of the neck. However, to fully realize the potential improvement in patient care afforded by the SLN procedure, a rapid and accurate SLN analysis is necessary. We used quantitative reverse transcription--PCR (QRT-PCR) to screen 40 potential markers for their ability to detect SCCHN metastases to cervical lymph nodes. Seven markers were identified with good characteristics for identifying metastatic disease, and these were validated using a set of 26 primary tumors, 19 histologically positive lymph nodes, and 21 benign nodes from patients without cancer. Four markers discriminated between positive and benign nodes with accuracy > >97% but only one marker, pemphigus vulgaris antigen (PVA), discriminated with 100% accuracy in both the observed data and a statistical bootstrap analysis. A rapid QRT-PCR assay for PVA was then developed and incorporated into a prototype instrument capable of performing fully automated RNA isolation and QRT-PCR. The automated analysis with PVA provided perfect discrimination between histologically positive and benign lymph nodes and correctly identified two lymph nodes with micrometastatic tumor deposits. These assays were completed ( from tissue to result) in f f30 minutes, thus demonstrating the feasibility of intraoperative staging of SCCHN SLNs by QRT-PCR. (Cancer Res 2005; 65(6): 2147-56)

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Section: Introductionmentioning

confidence: 99%

Molecular Staging of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck

Ferris

Raja³

et al. 2005

Cancer Research

101

119

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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: 67%

“…[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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“…Occult metastasis is another factor that should not be overlooked. Rates of occult metastatic nodes have been reported in 18% to 53% of T1 to T2 oral tongue carcinomas, (Lydiatt et al, 1993;Haddadin et al, 1999) 17% to 37% of T1 to T2 floor-of-mouth carcinomas (Mohit-Tabatabai et al, 1986, McGuirt et al, 1995, Nason et al, 1990) and 26% of T2 or greater buccal mucosa carcinomas (Diaz et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

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

Balasundram

Mustafa²,

Ip³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Floor of Mouth Carcinoma: The Management of the Clinically Negative Neck

Cited by 129 publications

References 20 publications

Molecular Staging of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck

Molecular Staging of Cervical Lymph Nodes in Squamous Cell Carcinoma of the Head and Neck

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

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

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