scholarly journals Guidelines for safe and optimum neck dissection: a review article

2021 ◽  
Author(s):  
Sheetal A. Murchite ◽  
Thakut Gowtham ◽  
Abhinandan Milind Kadiyal ◽  
Vaishali Vinayak Gaikwad ◽  
Ashutosh Tiwari
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Dissection ◽  
Early Stage ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Regional Lymph Nodes ◽  
Cervical Lymph Nodes ◽  
Early Stage Disease ◽  
Regional Metastases

Head and neck cancer is the sixth most common cancer worldwide. The single most important factor affecting prognosis for squamous cell carcinoma is the status of the cervical lymph nodes. Metastasis to the regional lymph nodes reduces the 5-year survival rate by 50% compared with that of patients with early-stage disease. The American cancer society reports that 40% of patients with squamous carcinoma of the oral cavity and pharynx present with regional metastases to the cervical lymph nodes. This activity presents the steps for safe and optimum neck dissection. Objectives of the study were to identify the anatomical structures in neck dissection, review the complications of head and neck surgery and summarize the importance of care coordination and to improve outcomes for patients undergoing head and neck surgery.

Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck.

1993 ◽  
Vol 11 (9) ◽  
pp. 1751-1756 ◽  
Author(s):  
D L Morton ◽  
D R Wen ◽  
L J Foshag ◽  
R Essner ◽  
A Cochran
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Drainage Basin ◽  
Lymphatic Mapping ◽  
Early Stage ◽  
Clinical Stage ◽  
False Negative ◽  
Regional Lymph Nodes ◽  
Cervical Lymph Nodes ◽  
Sentinel Nodes

PURPOSE We developed intraoperative lymphatic mapping with selective lymphadenectomy (SLND) to identify micrometastatic spread of cutaneous melanoma to regional lymph nodes. This study was undertaken to assess the sensitivity and specificity of our technique in patients with clinical stage I (CS-I) melanoma of the head or neck. PATIENTS AND METHODS Seventy-two CS-I melanoma patients underwent intraoperative lymphatic mapping of primary cutaneous melanomas located on the head, neck, or upper chest/back draining to the neck. Key (sentinel) cervical lymph nodes in the regional lymphatic drainage basin were identified, selectively excised during SLND, and examined for microscopic evidence of tumor cells. If these sentinel nodes were tumor-negative, the surgery was concluded; if the sentinel nodes were tumor-positive, all nodes in the drainage basin were removed during en bloc lymphadenectomy (LND). RESULTS Intraoperative lymphatic mapping identified sentinel nodes in 90% of the regional drainage basins. Fifteen percent of these nodes were tumor-positive, indicating the need for LND. There were no false-negative sentinel nodes, and extended follow-up showed no local nodal recurrences in patients whose sentinel-node histology did not indicate the need for LND. CONCLUSION Intraoperative lymphatic mapping and SLND is a minimally invasive and highly accurate screening technique for determining which patients with CS-I head and neck melanomas have subclinical node metastases and therefore might benefit from cervical LND.

scholarly journals Occult metastases of oral cavity cancers

2004 ◽  
Vol 51 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Milovan Dimitrijevic ◽  
A. Mikic ◽  
Z. Petrovic ◽  
Ivica Pendjer ◽  
Snezana Jesic ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Lymph Nodes ◽  
Neck Dissection ◽  
Malignant Tumors ◽  
Tongue Cancer ◽  
Regional Lymph Nodes ◽  
Term Survival ◽  
Occult Metastases ◽  
Floor Of Mouth ◽  
Regional Metastases

Despite new approaches to treatment and lower mortality, malignant tumors of the head and neck, including the malignant tumors of the oral cavity, still represent significant oncological problem because long-term survival has not been significantly prolonged. The growth of tumors of this localization is fast and infiltrative. while early metastases of regional lymph nodes are rather frequent. Malignant tumors of the oral cavity account for 1.1% of population in our community (Dimitrijvic, 2001). The objective of the study was to analyze regional metastases of the cancers of the tongue and the floor of mouth in 101 patients with planocellular cancers treated in the period 1991 to 1995.Clinically positive regional lymph nodes were found in 67.3% of patients, while the most commonly involved regions were submandibular (47.4%) and upper jugular region (46.1%). They were more frequent in localization of the floor of mouth than in case of tongue cancer. Three types of neck dissections were used for surgical treatment of patients. In the group of patients with clinically negative results of the neck (NO) who underwent neck dissection, occult metastases of regional lymph nodes were verified pathohistologically in 19.2% of the time. Malignant tumors of the oral cavity are always the indication for neck dissection, even in NO category, on account of high proportion of occult metastases.

The Importance of Metastatic Cervical Lymph Nodes on the Prognosis and Therapy of Malignant Neoplasias of the Head and Neck

1976 ◽  
Vol 62 (5) ◽  
pp. 473-484 ◽  
Author(s):  
Abrão Rapoport
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Critical Analysis ◽  
Prognostic Value ◽  
Radical Neck Dissection ◽  
Cervical Lymph Nodes ◽  
The Real

The author in a study of 667 patients submitted to unilateral or bilateral radical neck dissection presents a critical analysis of clinical palpatory and histopathological methods in the evaluation of the metastatical lymph nodes in head and neck cancer. The advantages of the last one are pointed out showing the real prognostic value of the histopathological metastases.

scholarly journals Therapeutic approach of cervical lymph nodes metastases of squamous cell carcinoma from an unknown primary tumors

2015 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Anca Ruxandra MOŞOIU ◽  
◽  
Alina Lavinia OANCEA ◽  
Roxana Mihaela MATEI ◽  
Marian STAMATE ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Unknown Primary ◽  
Cervical Lymph Nodes ◽  
Node Metastases

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.

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