Selective Neck Dissection of Anatomically Appropriate Levels Is as Efficacious as Modified Radical Neck Dissection for Elective Treatment of the Clinically Negative Neck in Patients With Squamous Cell Carcinoma of the Upper Respiratory and Digestive Tracts

1998 ◽  
Vol 124 (3) ◽  
pp. 348 ◽  
Author(s):  
Gary L. Clayman ◽  
Douglas K. Frank
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Selective Neck Dissection ◽  
Modified Radical Neck Dissection ◽  
Elective Treatment ◽  
Upper Respiratory

scholarly journals Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 269 ◽  
Author(s):  
Shunichi Shimura ◽  
Kazuhiro Ogi ◽  
Akihiro Miyazaki ◽  
Shota Shimizu ◽  
Takeshi Kaneko ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Selective Neck Dissection ◽  
Neck Node ◽  
Node Positive

The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p < 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p < 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated.

scholarly journals Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract

2008 ◽  
Vol 126 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Jamile Karina Antonio ◽  
Marcelo Benedito Menezes ◽  
Norberto Kodi Kavabata ◽  
Antonio Augusto Tupinambá Bertelli ◽  
William Kikuchi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Aerodigestive Tract ◽  
Selective Neck Dissection ◽  
Upper Aerodigestive Tract ◽  
Disease Evolution ◽  
Node Positive

CONTEXT AND OBJECTIVE: Modified radical neck dissection (MRND) is the classical treatment for neck metastases of squamous cell carcinoma (SCC) of the upper aerodigestive tract. However, it may still be accompanied by significant sequelae. One alternative for this treatment would be selective neck dissection (SND), which has a lower incidence of sequelae. The aim of this study was to define which neck metastasis cases would really be suitable candidates for SND. DESIGN AND SETTING: Retrospective clinical-surgical trial at the Division of Head and Neck Surgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP). METHODS: We retrospectively studied 67 patients with SCC of the upper aerodigestive tract, divided into two groups: 1) 47 patients treated by means of SND (node-negative or node-positive), 2) 20 patients treated by means of MRND (all node-positive). RESULTS: Our results demonstrated that there was no difference between the patients treated with SND or MRND in relation to disease evolution, and that the main prognostic factor was lymph node involvement. We observed that patients with pharyngeal SCC and older patients presented worse evolution and would probably not be suitable candidates for SND. CONCLUSIONS: SND may be a good option for treating node-positive necks in selected cases.

scholarly journals Dissection of posterior triangle and lower deep jugular lymph node is mandatory in therapeutic neck dissection as a part of treatment for squamous cell carcinoma of oral cavity with clinically N1 neck

2019 ◽  
Vol 5 (6) ◽  
pp. 1517
Author(s):  
Shilpa R. ◽  
Azeem Moyihuddin
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Oral Cancer ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Modified Radical Neck Dissection ◽  
Posterior Triangle

<p class="abstract"><strong>Background:</strong> In India oral cancer is the commonest malignant neoplasm, accounting for 20-30% of all cancers. Southern India presents the highest oral cancer incidence rates among women worldwide.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in R. L. Jalappa Hospital and Research Centre and SDU Medical College Kolar, Karnataka. Thirty patients having oral squamous cell carcinoma with clinically N<sub>1 </sub>neck undergoing modified radical neck dissection between December 2010 and June 2012 were enrolled in the study. The objective of study was to determine whether dissection of posterior triangle and lower deep jugular lymph node is mandatory in therapeutic neck dissection as a part of treatment for squamous cell carcinoma of oral cavity with clinically N<sub>1 </sub>neck.  </p><p class="abstract"><strong>Results:</strong> Out of 24 patients, 16 patients underwent wide excision with hemimandibulectomy. In these 16 cases, 2 patients had reconstruction with double flap while rest 14 cases with island pectoralis major myocutaneous flap. Out of remaining 8 patients, 2 patients underwent marginal mandibulectomy. In all these 8 patients, reconstruction was done using nasolabial flap in 1 patient, buccal pad of fat in 2 patients, masseter flap in 1 patient and forehead flap in 4 patients. In carcinoma anterior 2/3<sup>rd</sup> tongue, all 6 patients underwent hemiglossectomy with simultaneous modified radical neck dissection.</p><p class="abstract"><strong>Conclusions:</strong> It was concluded that during neck dissection, it may be oncologically safe to avoid level IV and level V clearance in buccal mucosa squamous cell carcinoma with N<sub>1</sub> neck.</p>

Oncological safety of the Hayes-Martin manoeuvre in neck dissections for node-positive oropharyngeal squamous cell carcinoma

2012 ◽  
Vol 126 (10) ◽  
pp. 1045-1048 ◽  
Author(s):  
F Riffat ◽  
M A Buchanan ◽  
A K Mahrous ◽  
B M Fish ◽  
P Jani
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Mandibular Nerve ◽  
Head And Neck Oncology ◽  
Oncological Safety ◽  
Modified Radical Neck Dissection ◽  
Marginal Mandibular Nerve

AbstractIntroduction:The Hayes-Martin manoeuvre involves ligation of the posterior facial vein and superior reflection of the investing fascia below the mandible to preserve the marginal mandibular nerve. The peri-facial nodes thus remain undissected. We perform this manoeuvre routinely during modified radical neck dissection for metastatic oropharyngeal squamous cell cancer. Here, we review the oncological safety and marginal mandibular nerve preservation rates of this manoeuvre from 2004 to 2009.Method:Retrospective review of the head and neck oncology database (2004–2009) at Addenbrooke's Hospital, Cambridge, UK, a tertiary referral centre for head and neck oncology.Results:Thirty-four patients underwent modified radical neck dissection for metastatic oropharyngeal squamous cell carcinoma. The primary tumour included the tonsil in 19 cases, base of tongue in 10 and posterior pharyngeal wall in 5. The neck nodal status was N1 in 4 cases, N2a in 11, N2b in 10, N2c in 4 and N3 in 5. All patients had adjuvant radiotherapy. Median follow up was four years (range, two to five). No peri-facial nodal region recurrences were seen. Four patients had temporary marginal mandibular nerve weakness; beyond two months, no weakness was seen.Conclusion:In neck dissections for oropharyngeal squamous cell carcinoma, the marginal mandibular nerve and accompanying facial nodes can be safely preserved without oncological risk using the Hayes-Martin manoeuvre.

Sign in / Sign up

Export Citation Format

Share Document