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Selective Neck Dissection for Clinically Node-Positive Oral Cavity Squamous Cell Carcinoma

 Yoo Seob Shin  ;  Yoon Woo Koh  ;  Se-Heon Kim  ;  Eun Chang Choi 
 YONSEI MEDICAL JOURNAL, Vol.54(1) : 139-144, 2013 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/pathology* ; Carcinoma, Squamous Cell/surgery* ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms/mortality ; Mouth Neoplasms/pathology* ; Mouth Neoplasms/surgery* ; Neck/surgery ; Neck Dissection* ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Retrospective Studies ; Treatment Outcome
Oral cavity cancer ; selective neck dissection ; therapeutic neck dissection ; level IV, level V
PURPOSE: The treatment of a clinically node-positive (cN+) neck is important in the management of oral cavity squamous cell carcinoma (OSCC). However, the extent of neck dissection (ND) remains controversial. The purpose of our study was to evaluate whether level IV or V can be excluded in therapeutic ND for cN+ OSCC patients. MATERIALS AND METHODS: We performed a retrospective chart review of 92 patients who underwent a comprehensive or selective ND as a therapeutic treatment of cN+ OSCC from January 1993 to February 2009. RESULTS: The incidence rate of metastasis to level IV or V was 22% (16 of 72) on the ipsilateral neck. Of 67 cases without clinically suspicious nodes at level IV or V, 11 cases (16%, 11 of 67) had pathologically proven lymphatic metastasis to level IV or V. Only a nodal staging above N2b was significantly relevant with the higher rate of level IV or V lymph node metastasis (p=0.025). In this series, selective ND, combined with proper adjuvant therapy, achieved regional control and survival rates comparable to comprehensive ND in patients under the N stage of cN2a OSCC. CONCLUSION: In conclusion, level IV and V patients can avoid recurrence under cN2a OSCC.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kho, Yoon Woo(고윤우)
Kim, Se Heon(김세헌)
Choi, Eun Chang(최은창)
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