A 3-year study of supraomohyoid neck dissection and modified radical neck dissection type I in oral cancer: with special reference to involvement of level IV node metastasis

The present study was undertaken to determine the pattern and incidence of predictable lymphatic spread and skip metastasis in oral cancer and analyze the prognostic implications of different therapeutic modalities in the neck metastases. The study includes 81 patients with squamous cell carcinoma o...

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Bibliographic Details
Published in:European archives of oto-rhino-laryngology 2010-06, Vol.267 (6), p.933-938
Main Authors: Mishra, Prakash, Sharma, Anjani Kumar
Format: Article
Language:English
Subjects:
Biological and medical sciences
Head and Neck
Head and Neck Surgery
Humans
Incidence
Lymph Nodes - pathology
Lymphatic Metastasis - pathology
Medical sciences
Medicine
Medicine & Public Health
Mouth Neoplasms - pathology
Mouth Neoplasms - surgery
Neck Dissection - methods
Neoplasm Invasiveness
Neoplasm Staging
Neurosurgery
Otorhinolaryngology
Otorhinolaryngology. Stomatology
Prognosis
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:The present study was undertaken to determine the pattern and incidence of predictable lymphatic spread and skip metastasis in oral cancer and analyze the prognostic implications of different therapeutic modalities in the neck metastases. The study includes 81 patients with squamous cell carcinoma of oral cavity with T1-2N0M0 and T1-3N1-3M0 who were admitted to the Department of ENT and Head and Neck Surgery, SMS Medical College and Hospital, Jaipur, from June 2006 to May 2008. After complete diagnostic evaluation (imaging, FNAC), all these patients were operated (wide primary excision with SOHND/Extended SOHND/MRD-I) and followed up periodically till date. Occult metastasis was found in 26% of the patients. Level I, II, III was most commonly involved. We did not find any metastasis or recurrence at level IV in N0 cases. Involvement of level IV node in N0 and N+ neck were 0 and 9%, respectively. We did not find any “skip metastasis” at level IV in oral cancers. We concluded that SOHND for N0 and MRND type I for N+ neck for oral cancers is an appropriate treatment.
ISSN:0937-4477
1434-4726
DOI:10.1007/s00405-009-1155-9