scholarly journals Elective neck dissection versus watchful waiting in the management of early tongue cancers with node negative neck: our experience of 68 cases

2021 ◽  
Author(s):  
Anchal Gupta ◽  
Rupali Sharma ◽  
Gopika Kalsotra ◽  
Arun Manhas ◽  
Dev Raj
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Primary Tumor ◽  
Surgical Excision ◽  
Tumor Thickness ◽  
Elective Neck Dissection ◽  
Node Metastasis

<p><strong>Background: </strong>Prognosis for tongue squamous cell carcinoma depends upon lymph node metastasis and the treatment plan depends upon the management of cervical lymph node metastasis.<strong></strong></p><p><strong>Methods: </strong>A prospective analysis of early squamous cell carcinoma oral tongue was done February 2017 to February 2020 in previously untreated and biopsy proven patients with T1-2N0 cancer of tongue and patients with clinically negative nodes on the basis of palpation, ultrasound and computerized tomography (CT) and previously untreated and biopsy proven patients with T1-2N0 cancer of oral cavity. After proper work up, patients were divided into two groups. Group 1 (n=35) patients that underwent a surgical excision of primary tumor with 15mm safe margin and selective neck dissection (level I, II, III), group 2 (n=33) patients that underwent surgical excision of primary tumor with 15 mm safe margin and neck observation. All patients with tumor thickness ≥4 mm were included in this group. </p><p><strong>Results: </strong>The study included 51 (75%) males and 17(25%) female patients. In this study, recurrence was significantly related to tumor thickness (p&lt;0.05) i.e., &gt;4 mm tumor thickness showed significantly higher local recurrence and nodal recurrences. Also, a significantly higher relationship was seen between nodal recurrence and postoperative close surgical margins (p&lt;0.05).</p><p><strong>Conclusions: </strong>Elective neck dissection becomes necessary in patients with T2N0 tumors and tumor thickness of &gt;4 mm as frequency of occult metastasis and recurrence is more in these patients.</p>

scholarly journals Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma?

2021 ◽  
Vol 11 ◽  
Author(s):  
Yassine Aaboubout ◽  
Quincy M. van der Toom ◽  
Maria A. J. de Ridder ◽  
Maria J. De Herdt ◽  
Berdine van der Steen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Early Stage ◽  
Elective Neck Dissection ◽  
Depth Of Invasion ◽  
Node Metastasis ◽  
Occult Lymph Node Metastasis

ObjectiveThe depth of invasion (DOI) is considered an independent risk factor for occult lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC). It is used to decide whether an elective neck dissection (END) is indicated in the case of a clinically negative neck for early stage carcinoma (pT1/pT2). However, there is no consensus on the cut-off value of the DOI for performing an END. The aim of this study was to determine a cut-off value for clinical decision making on END, by assessing the association of the DOI and the risk of occult lymph node metastasis in early OCSCC.MethodsA retrospective cohort study was conducted at the Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Patients surgically treated for pT1/pT2 OCSCC between 2006 and 2012 were included. For all cases, the DOI was measured according to the 8th edition of the American Joint Committee on Cancer guideline. Patient characteristics, tumor characteristics (pTN, differentiation grade, perineural invasion, and lymphovascular invasion), treatment modality (END or watchful waiting), and 5-year follow-up (local recurrence, regional recurrence, and distant metastasis) were obtained from patient files.ResultsA total of 222 patients were included, 117 pT1 and 105 pT2. Occult lymph node metastasis was found in 39 of the 166 patients who received END. Univariate logistic regression analysis showed DOI to be a significant predictor for occult lymph node metastasis (odds ratio (OR) = 1.3 per mm DOI; 95% CI: 1.1–1.5, p = 0.001). At a DOI of 4.3 mm the risk of occult lymph node metastasis was &gt;20% (all subsites combined).ConclusionThe DOI is a significant predictor for occult lymph node metastasis in early stage oral carcinoma. A NPV of 81% was found at a DOI cut-off value of 4 mm. Therefore, an END should be performed if the DOI is &gt;4 mm.

Level IIb lymph node metastasis in elective neck dissection of oropharyngeal squamous cell carcinoma

Oral Oncology ◽  
2006 ◽  
Vol 42 (10) ◽  
pp. 1017-1021 ◽  
Author(s):  
Sei Young Lee ◽  
Young Chang Lim ◽  
Mee Hyun Song ◽  
Jin Seok Lee ◽  
Bon Seok Koo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Elective Neck Dissection ◽  
Node Metastasis

scholarly journals The relationship between primary tumour thicknesses in cancers of the oral cavity to subsequent lymph node metastasis

2017 ◽  
Vol 4 (9) ◽  
pp. 2957
Author(s):  
Ahmed Fawzy ◽  
Waleed Ali Al zaqri ◽  
Mohamed Sabry ◽  
Ahmed Sabry ◽  
Hosam El Fol ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Cavity ◽  
Neck Dissection ◽  
Tumor Thickness ◽  
Elective Neck Dissection ◽  
Pathological State ◽  
Cervical Lymph Nodes ◽  
Node Metastasis ◽  
Oral Cavity Cancers

Background: Elective dissection of cervical lymph nodes in oral cavity cancers gives very precious data on its pathological state, judge for adjuvant therapy requirement plus its therapeutic effect but it has its morbidities that cannot be condoned. Tumor thickness (TT) in oral cavity cancers show an increasing value to be one of the most important and reliable factors that have a great relationship to regional node involvement.Methods: Forty-three patients with T1, T2 oral cavity squamous cell carcinoma with clinically and radiologically negative cervical L.Ns underwent elective neck dissection and the relation between the tumor thickness and the nodal metastasis was monitored. Tumor thickness was estimated preoperatively by using the intra-oral ultrasound and confirmed by histopathology postoperatively.Results: Only 12 out of 43 neck dissections (27.9%) showed positive L.Ns metastasis of primary tumor. The excised number of L.Ns ranged from 15 to 31 with mean±SD (21.58±3.59) L.Ns. The (TT) ranged from 1.4 mm to 7.8 mm. Our statistical results showed that there is a cutoff point which was 4 mm where (TT) > 4 mm showed significant results with histologically found positive cervical node metastasis compared to (TT) ≤4 mm specimens.Conclusions: Relationship of tumor thickness to lymph node metastasis was found to be significant as shown by this study. Our results clearly demonstrate that conservative elective neck dissection is indicated in patients with stage I/II oral cavity carcinoma whose tumors are > 4 mm in thickness as they mostly have latent metastasis. 

scholarly journals Gene Expression Comparison Between the Primary Tumor and its Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma: A Pilot Study

2019 ◽  
Vol 16 (3) ◽  
pp. 155-161
Author(s):  
GEORGIA KARPATHIOU ◽  
MARIE-LAURIE STACHOWITZ ◽  
JEAN MARC DUMOLLARD ◽  
MARIE GAVID ◽  
MARIOS FROUDARAKIS ◽  
...  
Keyword(s):  
Gene Expression ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Pilot Study ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Node Metastasis

Tumor thickness and risk of lymph node metastasis in patients with squamous cell carcinoma of the tongue

Oral Oncology ◽  
2016 ◽  
Vol 53 ◽  
pp. 80-84 ◽  
Author(s):  
Thomas Mücke ◽  
Anastasios Kanatas ◽  
Lucas M. Ritschl ◽  
Steffen Koerdt ◽  
Andrea Tannapfel ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tumor Thickness ◽  
Node Metastasis ◽  
Carcinoma Of The Tongue
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