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

Abstract

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.