Extent of neck dissection for patients with clinical N1 oral cancer

Int J Clin Oncol. 2020 Jun;25(6):1067-1071. doi: 10.1007/s10147-020-01635-8. Epub 2020 Mar 5.

Abstract

Background: No clear consensus has been reached on the indication of supraomohyoid neck dissection (SOHND) for clinically positive lymph-node metastasis.

Patients: Consecutive 100 patients with previously untreated oral cancer treated at Kobe University Hospital were included in this study. All patients were clinically staged as anyTN1M0 and underwent radical dissection of the primary site and level I-V neck dissection as the initial treatment.

Results: None of the 100 patients had pathological lymph-node metastasis (pLN) to level V. pLN to level IV was observed in two patients with tongue cancer in whom clinical lymph-node metastasis was preoperatively observed at level II.

Conclusions: Level V may be excluded in the neck dissection for patients with N1 oral cancers. Level IV dissection should be considered in the patient with tongue cancer and clinical lymph-node metastasis at level II.

Keywords: Clinical N1; Level IV; Level V; N1; Neck dissection; Oral cancer; Supraomohyoid neck dissection; Tongue cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / surgery*
  • Neck Dissection* / methods
  • Neck Dissection* / standards
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / surgery