Lymph node management in the treatment of oral cancer: Analysis of a standardized approach

详细信息    查看全文

• 作者：Steffen Koerdt ; ¹ ; ^{steffen.koerdt@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Jonas Rö ; ckl¹ ; Niklas Rommel ; Thomas Mü ; cke ; Klaus-Dietrich Wolff ; Marco R. Kesting
• 关键词：Neck dissection ; Oral cancer ; Lymphadenectomy ; Squamous cell carcinoma ; Mouth neoplasms
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：44
• 期：10
• 页码：1737-1742
• 全文大小：564 K

文摘

A supraomohyoid neck dissection (SOHND) is part of the surgical management of patients with oral cancer, even in the absence of clinical or radiographic evidence of neck disease. We have investigated a standardized approach to the management of cervical lymph nodes, in patients with a primary oral cancer. A modified surgical technique has been presented and a clinical algorithm has been described and evaluated.

Materials and methods

SOHND was performed either uni- or bi-laterally. In cases of positive nodes in levels II or III, the dissection was extended in terms of a modified radical neck dissection (MRND) and a SOHND was performed contralaterally.

Results

112 patients were included. 42% had lymph node metastases in any level. Overall, lymph node metastases were found in 2.8% of all examined nodes. Most metastases (34.6%) occurred in level Ib. 12.6% were located in level IIb. No metastases could be detected in levels IV and V. No statistically significant difference could be shown with regard to T-stage, location, or co-factors as gender and age.

Discussion

SOHND is the gold-standard in patients with no preoperative evidence of lymph node metastases. The presented algorithm is able to facilitate dissection and histological analysis and might improve the surgical care in current treatment concepts. The extension to an MRND facilitates the identification of patients in need of adjuvant therapy.