Salvage neck dissections in oral and oropharyngeal squamous cell carcinoma: histological features in relation to disease category

The histological findings in a series of 37 salvage neck dissections from patients who had an oral or oropharyngeal squamous cell carcinoma managed initially by primary surgery with or without neck dissection, and without postoperative radiotherapy, are described. None of the cases had an intraoral...

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Bibliographic Details
Published in:International journal of oral and maxillofacial surgery 2006-10, Vol.35 (10), p.907-912
Main Author: Woolgar, J.A.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Carcinoma, Squamous Cell - secondary
Carcinoma, Squamous Cell - surgery
Dentistry
Female
Humans
Lymphatic Metastasis
Male
Medical sciences
Middle Aged
Mouth Neoplasms - pathology
Mouth Neoplasms - surgery
Neck Dissection
Neoplasm Staging - methods
nodal metastasis
oral cancer
oral squamous cell carcinoma
Oropharyngeal Neoplasms - pathology
Oropharyngeal Neoplasms - surgery
Otorhinolaryngology. Stomatology
regional relapse
salvage neck dissections
Salvage Therapy
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:The histological findings in a series of 37 salvage neck dissections from patients who had an oral or oropharyngeal squamous cell carcinoma managed initially by primary surgery with or without neck dissection, and without postoperative radiotherapy, are described. None of the cases had an intraoral relapse. Pathological stage N2 or N3 disease was seen in 87% of the 15 salvage dissections from ‘wait and watch’ necks, 100% of the 10 salvage dissections of contralateral necks and 50% of the 12 salvage dissections of operated necks. The typical ‘inverted-cone’ pattern of metastasis was seen in 87% of ‘wait and watch’ necks. Skip or non-contiguous metastases to level III/IV accounted for relapse in 30% of the contralateral and 66% of the operated necks. The median time interval between original surgery and the salvage neck dissection was 15 months (range 1–48 months). In at least 15% of cases, the short time interval coupled with the histopathological features suggested that the metastatic disease suddenly became more rapidly progressive following removal of the primary tumour.
ISSN:0901-5027
1399-0020
DOI:10.1016/j.ijom.2006.08.003