scholarly journals Selective Neck Dissection (IIa, III): A Rational Replacement for Extended Supraomohyoid Neck Dissection in Patients with N0 Supraglottic and Glottic Squamous Cell Carcinoma

2015 ◽  
Vol 8 ◽  
pp. CMENT.S19874 ◽  
Author(s):  
Ismail Zohdi ◽  
Louay S. El Sharkawy ◽  
Mahmoud F. El Bestar ◽  
Hazem M. Abdel Tawab ◽  
Mo'men A.A. Hamela ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Neck Dissection ◽  
P Value ◽  
Selective Neck Dissection ◽  
Supraglottic Cancer ◽  
Node Metastasis ◽  
Supraomohyoid Neck Dissection ◽  
Is Value

Objectives To evaluate the effectiveness of selective neck dissection of sublevel IIa and level III in cases of glottis and supraglottic laryngeal carcinoma in the absence of lymph node metastasis and to show if there is value in dissecting the sublevel IIb or level IV in these cases. Patients and Methods Twenty-five patients with N0 glottic or supraglottic cancer were subjected to unilateral or bilateral selective neck dissection according to the site and the extent of the tumor, and the specimens were histopathologically examined for metastasis. Results Twenty-five patients (23 males and 2 females) with mean age of 55.72 years were included in the study. Lymph node metastasis to sublevel IIa and level III was found in 6/25 (24%) cases with glottic or supraglottic carcinoma, while to sublevel IIb and level IV was found in 1/25 (4%) with P-value of 0.05, which is statistically significant. Conclusion Selective neck dissection of level IIb is not required in cases of the supraglottic laryngeal cancer. Dissection of sublevel IIa and level III takes less time and is effective. Dissection of level IV is not needed in the case of supraglottic cancer.

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.

Patients with unilateral squamous cell carcinoma of the tongue and ipsilateral lymph node metastasis do not profit from bilateral neck dissection

2018 ◽  
Vol 22 (2) ◽  
pp. 185-192
Author(s):  
Christoph Klingelhöffer ◽  
Andreas Gründlinger ◽  
Gerrit Spanier ◽  
Stephan Schreml ◽  
Maximilian Gottsauner ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Node Metastasis ◽  
Bilateral Neck Dissection ◽  
Carcinoma Of The Tongue

scholarly journals Anneroth’s Histopathological Grading System in Non Metastatic and Metastatic Oral Squamous Cell Carcinoma- A Pilot Study

2021 ◽  
Author(s):  
Ambika Murugesan ◽  
Sekar Balakrishnan ◽  
Manoj Chandrasekar ◽  
K Indrapriyadharshini ◽  
Ravi Saranyan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Pilot Study ◽  
Lymph Node Metastasis ◽  
Oral Squamous Cell Carcinoma ◽  
Regional Lymph Node ◽  
P Value ◽  
Grading System ◽  
Node Metastasis ◽  
Histopathological Grading

Introduction: Prognostic evaluation of Oral Squamous Cell Carcinoma (OSCC) is mainly based on [Tumour (T), Nodes (N), and Metastases (M)] staging. To predict the biological and clinical behaviour of a tumour, histological grading systems plays an important role. Modified Anneroth’s grading system includes three parameters each for histologic features and tumour-host relationship. Aim: To compare and analyse the histological features of tumour center and periphery of non metastatic and metastatic OSCC according to Anneroth’s histopathological classification and its association with regional lymph node metastasis. Materials and Methods: A retrospective pilot study was conducted on 20 histopathologically proven cases of OSCC collected from the Department of Oral Pathology and Oral Microbiology, Vinayaka Mission’s Sankarachariyar Dental College, Salem, Tamil Nadu, India. The OSCC cases those reported from March 2018 to June 2020 were included in the study. Among 20 cases, 10 non metastatic and 10 metastatic cases, were retrieved from archival blocks. Scores for the morphology and tumour-host relationship of non metastatic and metastatic tumours was assessed and graded by Anneroth’s grading system; then compared with the Broder's histopathological grading system. The histopathological scoring of lymph node was based on TNM staging. Chi-square test and Spearman’s correlation coefficient analysis was done. Results: Anneroth’s grading system showed a significant difference in pattern of invasion in tumour periphery of metastatic OSCC (p-value=0.01). Compared to Broder’s, Anneroth’s classification showed a highly significant corelation with lymph node metastasis (p-value=0.001). Conclusion: Hence, Anneroth’s histopathological grading system can be used to predict the biological changes in metastatic and non metastatic OSCC and its increased possibility of regional lymph node metastasis.

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