scholarly journals Detection of Cervical Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Oral Cavity, Pharynx and Larynx

2015 ◽  
Vol 58 (2) ◽  
pp. 62-65 ◽  
Author(s):  
Petr Čelakovský ◽  
David Kalfeřt ◽  
Katarína Smatanová ◽  
Viktor Chrobok ◽  
Jan Laco

Background: The goal of this prospective study was to determine the frequency of micrometastases in patients with squamous cell carcinoma (SCC) of the oral cavity, pharynx and larynx in whom elective neck dissection was indicated (cN0). Patients and Methods: A total of 12 patients (10 males and 2 females) were enrolled in the study. The age ranged 42–73 years (median 62 years). Elective neck dissection was performed in all patients (8 ipsilateral, 4 bilateral) and a total of 256 lymph nodes were removed and sent for microscopic examination. Results: The presence of tumor cells in cervical lymph nodes was found in 5/12 (42%) patients. Micrometastases of SCC were found in two patients and isolated tumor cells (ITC) in two other patients. In the remaining one patient with oropharyngeal SCC, a micrometastasis of papillary thyroid carcinoma (PTC) was detected. Positive lymph nodes were localized in level II in three patients with SCC of larynx, hypopharynx and tongue base, respectively, in level I in one patient with SCC of oral tongue and in level III in one patient with PTC. Conclusion: Our results indicate that SCC of head and neck has a high potential for creating micrometastases which frequency is higher compared to clinically detected macrometastases. Therefore, elective neck dissection or radiotherapy of the neck should be considered in patients with high risk of occult metastases or micrometastases.

1997 ◽  
Vol 106 (9) ◽  
pp. 787-789 ◽  
Author(s):  
Can Koç ◽  
M. Umut Akyol ◽  
Ali Çekiç ◽  
Serdar Çelikkanat ◽  
Cafer Özdem

Treatment of squamous cell carcinoma of the lip is primarily surgical. Unlike other oral lesions, lower lip cancers do not metastasize to lower cervical lymph nodes without invading submental and submandibular lymph nodes. This study presents 30 patients with NO lower lip carcinoma who were treated by en bloc resection of the tumor with suprahyoid neck dissection. Occult metastasis was found in 4 patients (13%). Four patients, 3 of whom had no occult metastases, died of local or regional uncontrollable disease. Suprahyoid or modified radical neck dissection appears to be beneficial, even in small tumors of the lower lip, in detecting occult metastases.


2021 ◽  
Author(s):  
Mattis Bertlich ◽  
Nina Zeller ◽  
Saskia Freytag ◽  
Bernhard G. Weiss ◽  
Martin Canis ◽  
...  

Abstract Background: Selective Neck Dissection (SND) is the surgical treatment of choice in suspected or manifest nodal positive squamous cell carcinoma of the head and neck (HNSCC). For SND to be successful, treated levels should be selected accordingly. Aim of this study was to identify neck dissection levels that had an impact on the individual prognosis.Methods: We conducted a retrospective review of SND as part of primary treatment of HNSCC. Overall survival (OS) and regional control rates (RCR) were calculated for all patients.Results: 661 patients with HNSCC were included, 644 underwent ipsilateral and 319 contralateral SND. Average follow up was 78.9 ± 106.4 months. 67 (10.1%) patients eventually developed nodal recurrence. Tumor sites were oral cavity (135), oropharynx (179), hypopharynx (118) and larynx (229). Tumor categories pT1 – pT4a, and all clinical and pathological nodal categories were included. Multivariate analysis indicated improved OS rates for patients undergoing SND in ipsilateral levels I and V as well as level III contralaterally. Analysis for tumor origin showed that SND in ipsilateral level I showed a significantly improved OS in HNSCC of the oral cavity.Conclusion: In HNSCC of the oral cavity, ipsilateral level I needs to be included when performing SND.


Oral Oncology ◽  
2020 ◽  
Vol 111 ◽  
pp. 104940 ◽  
Author(s):  
Cornelia G.F. van Lanschot ◽  
Yoram P. Klazen ◽  
Maria A.J. de Ridder ◽  
Hetty Mast ◽  
Ivo ten Hove ◽  
...  

1991 ◽  
Vol 21 (2) ◽  
pp. 100-106 ◽  
Author(s):  
P. Piedbois ◽  
J-J. Mazeron ◽  
E. Haddad ◽  
A. Coste ◽  
M. Martin ◽  
...  

2021 ◽  
Vol 43 (3) ◽  
pp. 293-299
Author(s):  
Nikzad Shahidi ◽  
Nastaran Zokaei

Background: Metastasis of aerodigestive tract cancers to cervical lymph nodes is one of the otolaryngologists’ concerns that relies on a variety of factors such as the size of the primary tumor and its spread. We aimed to study the prevalence of occult cervical metastases in patients with clinical N0 neck in oral cavity squamous cell carcinoma. Methods: In this cross-sectional analytic study, the researchers referred to the archive of Emam Reza Hospital and studied medical files of patients with a definite diagnosis of oral cavity squamous cell carcinoma admitted from April 2011 to April 2016 while collecting relevant data such as age, gender, size of the primary mass, place of the lesion, clinical and pathological nodal involvement. The data was analyzed employing SPSS 19 whereas the statistical significance level in all exams was set at 0.05. Results: Average age of participants was 61.67 ± 14.02, and they were mostly male. Forty-five percent of participants had a clinical N0 neck and the majority of them didn’t have metastasis in the pathological study. The prevalence of metastatic lymph nodes in patients with clinical N0 was 30%. No significant relationship was observed between the number of lymph nodes containing occult metastasis and T of the tumor (P = .578). Conclusion: In squamous cell carcinoma of oral cavity, the prevalence of metastatic lymph nodes in the neck is 30% and is significantly related to the location of the lesion while no significant relationship to T of the tumor is observed.


2015 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Anca Ruxandra MOŞOIU ◽  
◽  
Alina Lavinia OANCEA ◽  
Roxana Mihaela MATEI ◽  
Marian STAMATE ◽  
...  

Cervical lymph node metastases of squamous cell carcinoma from occult primary constitute about 3-5% of all patients with carcinoma of unknown primary site (CUP). Identification of subgroups with favorable prognosis is of decisive importance for the therapy of patients with CUP syndrome, including prolonged survival from directed treatment. The patients with neck node metastases from occult head and neck cancer have clinical features and prognosis similar to other head and neck malignancies. Treatment of patients with metastatic squamous cell carcinoma involving cervical lymph nodes of an unknown primary origin should be similar to that of patients with locally advanced carcinoma of the head and neck. Therapeutic approaches include surgery (lymph node excision or neck dissection), with or without post-operative radiotherapy, radiotherapy alone and radiotherapy followed by surgery. In early stages (N1), neck dissection and radiotherapy seem to have similar efficacy, whereas more advanced cases (N2, N3) necessitate combined approaches. The extent of radiotherapy (irradiation of bilateral neck and mucosa versus ipsilateral neck radiotherapy) remains debatable. A potential benefit from extensive radiotherapy should be weighted against its acute and late morbidity and difficulties in re-irradiation in the case of subsequent primary emergence. The role of other methods, such as chemotherapy and hyperthermia, remains to be determined.


2019 ◽  
Vol 9 (3) ◽  
pp. 24-28
Author(s):  
А. М. Mudunov ◽  
B. I. Dolgushin ◽  
А. А. Аkhundov ◽  
М. N. Narimanov ◽  
D. А. Safarov ◽  
...  

The objective is using a clinical example to demonstrate the possibilities of intra-arterial polychemotherapy (PCT) in the combined treatment of oral squamous cell carcinoma.Clinical case. A 43-year-old oral squamous cell carcinoma patient with metastases to cervical lymph nodes, left side (T3N2bM0, stage IV) underwent 2 courses of regional neoadjuvant intra-arterial PCT (docetaxel at a dose of 105 mg, cisplatin at a dose of 105 mg), accessed through a. lingualis. A total dose of 6,800 mg of 5-fluorouracil was administered as a 96-hour infusion. PCT induced oral mucositis of grade 2, no hematological side effects were observed. Clinical examination revealed that tumor volume decreased by 60 %. Ultrasound detected no changes in lymph nodes. Second step included resection of oral cavity bottom tissues, atypical tongue resection, marginal resection of the lower jaw on the left, radical neck dissection on the left. Histological study of the surgical material of primary tumor region as well as metastases of the cervical lymph nodes on the tumor side revealed pathomorphism of 4 grade. In the postoperative period, oral cavity and neck were irradiated from 2 sides. No signs of the disease were detected within 9 months after the combined treatment.Conclusion. The clinical case demonstrates the high efficiency of regional intra-arterial PCT in patients with locally invasive oral squamous cell carcinoma. It seems relevant to further study its possibilities in the combined treatment of locally invasive forms of oral squamous cell carcinoma.


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