The role of selective neck dissection (I–III) in the treatment of node negative (N0) neck in oral cancer

Iype, Elizabeth Mathew; Stolzmann, Paul; Mathew, Aleyamma; Balagopal, P.G.; Varghese, Bipin T.; Thomas, Shaji

doi:10.1016/j.oraloncology.2008.02.017

Cited by 52 publications

(43 citation statements)

References 18 publications

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“…When an adjuvant irradiation was conducted (p = 0.056), the recurrence rate in pN? patients was reduced to 11% [25]. In our study, the absence of recurrences in all 6 patients with pN?…”

Section: Discussionsupporting

confidence: 40%

Metastatic pattern in squamous cell carcinoma of the hard palate and maxillary alveolar ridge: clinical experience and review of the literature

et al. 2017

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Purpose Oral squamous cell carcinoma of the hard palate and upper alveolar ridge is rare with only few published current data regarding regional metastases after elective neck dissection or adjuvant therapy. Our aim was to investigate the incidence of initial and delayed nodal metastasis and to identify predictive factors. Methods In a retrospective cohort study, we enrolled 48 primarily surgical-treated patients from 2004 to 2014. Results Pathological initial nodal metastasis rate was 13.3% (6/45). Poor histologic grade (p = 0.048), lymphovascular infiltration (p \ 0.001) and perineural infiltration (p = 0.01) correlated with initial nodal metastasis, while advanced T-stage showed no significance (p = 0.07). Regional recurrences occurred in 14.6% of patients (7/48) and tended to emerge less frequently after therapeutic than elective neck dissection. Tumor involvement of the vestibular alveolar mucosa was a prognostic factor for developing regional recurrence (p = 0.034). Overall nodal disease rate was 27.1% (13/48). Disease-free and overall survival rates were at 73 and 93%, respectively. Conclusions The presence of poor histologic characteristics is a high risk for nodal metastasis. In patients with tumors in contact with the upper vestibular fold, the hypothesis of an impact on metastasis needs further validation.

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“…When an adjuvant irradiation was conducted (p = 0.056), the recurrence rate in pN? patients was reduced to 11% [25]. In our study, the absence of recurrences in all 6 patients with pN?…”

Section: Discussionsupporting

confidence: 40%

Metastatic pattern in squamous cell carcinoma of the hard palate and maxillary alveolar ridge: clinical experience and review of the literature

et al. 2017

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“…The extent of elective and therapeutic neck dissections still however remains a contentious issue [12,13].The major morbidity circumvented in modified neck dissections is the preservation of spinal accessory nerve function. This ensures prevention of shoulder dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?

Dabholkar

Kapre

2015

Indian J Surg Oncol

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Nodal metastases is the most important prognostic marker for oral cavity cancers. Nodal dissection at level IIb risks damage to the spinal accessory nerve. We aim to study positivity of level IIb lymph nodes in oral cancers. In this non-randomized prospective observational study, 65 patients of oral cavity cancers were evaluated. Appropriate surgery for primary tumour and neck dissection were undertaken. All patients underwent level II b dissection. Out of 67 neck dissections (27 elective and 40 therapeutic), 7 patients had level IIb positive for metastases (10.44 %) with no isolated or contralateral metastases at level IIb and direct correlation with level IIa nodes. There was no statistical association of level IIb positivity with stage or site of primary. Level IIb dissection can be avoided in N0 necks. For therapeutic neck dissections, Level IIb should be cleared if there are positive nodes at level IIa.

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“…In comparison, routine elective ND for cN0 squamous cell carcinoma carries an approximately 1.6-10% rate of regional recurrence [53][54][55]. The amount of prospective high-quality evidence and the relatively long follow-up in observational studies has led to the routine utilization of this technique for early oral cavity and oropharyngeal carcinoma in some major cancer centers [56].…”

Section: Sentinel Node Biopsymentioning

confidence: 99%

Minimally invasive techniques for head and neck malignancies: current indications, outcomes and future directions

Hartl

Ferlito

Silver

et al. 2011

Eur Arch Otorhinolaryngol

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The trend toward minimally invasive surgery, appropriately applied, has evolved over the past three decades to encompass all fields of surgery, including curative intent cancer surgery of the head and neck. Proper patient and tumor selection are fundamental to optimizing oncological and functional outcomes in such a personalized approach to cancer treatment. Training, experience, and appropriate technological equipment are prerequisites for any type of minimally invasive surgery. The aim of this review was to provide an overview of currently available techniques and the evidence justifying their use. Much evidence is in favor of routine use of transoral laser resection, transoral robot-assisted surgery, transnasal endoscopic resection, sentinel node biopsy, and endoscopic neck surgery for selected malignant tumors, by experienced surgical teams. Technological advances will enhance the scope of this type of surgery in the future and physicians need to be aware of the current applications and trends.

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The role of selective neck dissection (I–III) in the treatment of node negative (N0) neck in oral cancer

Cited by 52 publications

References 18 publications

Metastatic pattern in squamous cell carcinoma of the hard palate and maxillary alveolar ridge: clinical experience and review of the literature

Metastatic pattern in squamous cell carcinoma of the hard palate and maxillary alveolar ridge: clinical experience and review of the literature

Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?

Minimally invasive techniques for head and neck malignancies: current indications, outcomes and future directions

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