Neck dissection in the nineteenth century

Folz, Benedikt J.; Ferlito, Alfio; Silver, Carl E.; Olofsson, Jan; Bradley, Patrick J.; Bień, Stanisław; Towpik, Edward; Weir, Neil; Rinaldo, Alessandra

doi:10.1007/s00405-007-0261-9

Cited by 9 publications

(6 citation statements)

References 12 publications

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“…Κάποιοι προσπάθησαν, χωρίς αποτέλεσμα, να θεραπεύσουν τέτοιες λεμφαδενικές τραχηλικές μεταστάσεις, με το να εκτέμνουν μόνο τις ογκώδεις τραχηλικές μεταστατικές μάζες. Αργότερα, όμως, εισήχθησαν πιο αποτελεσματικές επεμβάσεις, που περιελάμβαναν εκτομή ακόμη και εκλεκτικά (κλινικά αρνητικός τράχηλος) πιθανής λεμφικής διασποράς από συγκεκριμένες πρωτοπαθείς εστίες (Folz 2007). Ο Crile πρόσθεσε, στις προηγούμενες ανομοιογενείς γνώσεις για την φύση και συμπεριφορά των τραχηλικών μεταστάσεων την δική του άποψη, οτι δηλαδή υπήρχε η δυνατότητα οι διηθημένοι τραχηλικοί λεμφαδένες να εκταμούν πιο συστηματικά, και να αντιμετωπιστούν οριστικά.…”

Section: Short Biography Of Crileunclassified

“…Such surgeries usually took place in terminal stage patients (bulky neck metastasis), in whom the radical dissection of the cancerous neck disease was, in essence, not feasible. Although they occasionally reported the survival of some patients up to 3 years, the majority of them died earlier from the disease, if not from the surgery (Folz et al 2007). In 1875 von Langenbeck (Langenbeck 1875) published 2 cases of patients with neck dissections of the disease including the inner jugular vein and the carotid.…”

Section: Introductionmentioning

confidence: 99%

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The history of Crile’s neck dissection

Lazaridis¹

2022

Hell Arch Oral Maxillofac Surg

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Section: Short Biography Of Crileunclassified

Section: Introductionmentioning

confidence: 99%

The history of Crile’s neck dissection

Lazaridis¹

2022

Hell Arch Oral Maxillofac Surg

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“…Consequently, OSCC is often treated with simultaneous neck dissection for either therapeutic, diagnostic, or prophylactic purposes. After Virchow first formulated the definition and emphasized the metastatic trend of malignant lesions in 1885 through "Cellular pathology", neck dissection as currently conceived emerged 6 , 7 . Later, radical neck dissection was introduced, becoming the standard in managing oral cancer metastatic lymph node 8 .…”

Section: Introductionmentioning

confidence: 99%

Predictive modelling of level IIb lymph node metastasis in oral squamous cell carcinoma

Yang

Son

Lee

et al. 2021

Sci Rep

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The aim of the present study was to examine the conditions, characteristics, and risk factors of level IIb lymph node metastases in oral squamous cell carcinoma and to formulate surgical criteria for level IIb lymph node dissection. We analyzed clinical and pathological records for 541 oral squamous carcinoma patients in relation to level IIb metastasis. Univariate and multivariate analyses were performed to detect risk factors for level IIb lymph node metastasis; a predictive model was built based on multivariate analysis and tested in a validation group. Univariate and multivariate analyses using the training group indicated that level IIa metastasis and Lymphovascular permeation (LVP) were two independent risk factors for level IIb lymph node metastasis. This model was built and tested in a validation group, the area under the curve being 0.697 (P < .0.001). The model’s sensitivity was 66.7% and specificity was 77.4%. Nomogram incorporating validated variables was developed for level IIb metastasis prediction. Expected survival probabilites were analysed to specify significance of model's variable on patients’ overall survival and recurrence. Level IIb dissection should be performed in patients with level IIa metastasis and LVP. However, thorough consideration of the oncologic safety of omitting level IIb dissection is compulsory.

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“…The concept of excision of metastatic cervical lymph nodes was not new. Nineteenth century surgeons were aware of the negative prognostic significance of cervical metastatic disease and had attempted to treat this problem, first by ineffective procedures to excise gross masses of metastatic tumor, later by more effective operations to remove, even electively, the lymphatic sheds of particular primary tumors, and eventually by a block resection of lymph node‐bearing tissue in the neck 3,4 . However, Crile (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…Nineteenth century surgeons were aware of the negative prognostic significance of cervical metastatic disease and had attempted to treat this problem, first by ineffective procedures to excise gross masses of metastatic tumor, later by more effective operations to remove, even electively, the lymphatic sheds of particular primary tumors, and eventually by a block resection of lymph node-bearing tissue in the neck. 3,4 However, Crile (Fig. 1) acquired previously unequaled insight into the nature of cervical lymph node metastatic disease, its amenability to surgical excision, the possibility of cure after accomplishing effective removal, and, particularly, a successful technique for en bloc resection of all the deep lymphatic structures in the neck.…”

Section: Introductionmentioning

confidence: 99%

Crile's Neck Dissection

2007

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George Crile, after a long experience with treatment of head and neck cancer and study of a large number of cases, appreciated that these tumors almost always drained through the lymphatic pathways of the neck, rarely metastasized distantly, and were thus theoretically curable by resection of the primary tumor and its lymphatic draining shed. After evaluation of his early failures, he found that a block resection of all of the lymph node-bearing tissue of the neck in addition to resection of the primary tumor was the most effective means of obtaining a cure, particularly in patients with clinical evidence of spread of disease to the neck. Such radical surgery, at the time, was fraught with difficulty because of the lack of blood transfusion, antibiotics, and endotracheal anesthesia, but Crile devised several strategies for combating these obstacles. Crile performed 36 such block resections with a determinate 3-year survival of 75% compared with 19% 3-year survival in patients who had not undergone block resection. The surgical precepts developed by Crile laid the foundation for the effective modern surgical treatment of head and neck cancer.

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Neck dissection in the nineteenth century

Cited by 9 publications

References 12 publications

The history of Crile’s neck dissection

The history of Crile’s neck dissection

Predictive modelling of level IIb lymph node metastasis in oral squamous cell carcinoma

Crile's Neck Dissection

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