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Occult level IV metastases in clinically node-negative patients with oral tongue squamous cell carcinoma

Published online by Cambridge University Press:  20 April 2016

M Motiee-Langroudi
Affiliation:
Otorhinolaryngology Research Center, Otolaryngology Department, Tehran University of Medical Sciences, Iran
A Amali
Affiliation:
Pathology Department, Tehran University of Medical Sciences, Iran
B Saedi
Affiliation:
Otorhinolaryngology Research Center, Otolaryngology Department, Tehran University of Medical Sciences, Iran
H Emami
Affiliation:
Otorhinolaryngology Research Center, Otolaryngology Department, Tehran University of Medical Sciences, Iran
F Ensani
Affiliation:
Pathology Department, Tehran University of Medical Sciences, Iran
A Lotfi
Affiliation:
Otolaryngology Department, Tehran University of Medical Sciences, Iran
M Rabbani Anari*
Affiliation:
Otorhinolaryngology Research Center, Otolaryngology Department, Tehran University of Medical Sciences, Iran
*
Address for correspondence: Dr M Rabbani Anari, Otolaryngology Department, Imam Khomeini Hospital Complex, Bagherkhan Street, Chamran Highway, Tehran 1419733141, Iran Fax: +98 216 658 1628 E-mail: [email protected]

Abstract

Objective:

The present study was conducted to determine the rate of level IV lymph node involvement among node-negative (N0) necks in patients with squamous cell carcinoma of the tongue.

Methods:

The study comprised 32 patients with squamous cell carcinoma of the tongue, with tumour–node–metastasis staging of T1–3N0M0, who were admitted to the Otolaryngology Department at Tehran University of Medical Sciences from March 2012 to March 2014. After a complete diagnostic evaluation, wide primary tumour excision (with 1.5–2 cm margins) and extended supraomohyoid neck dissection (levels I–IV) were accomplished.

Results:

Occult metastasis was found in 28 per cent of the patients. Level I, II and III metastases were the most common (18.75, 18.75 and 15.62 per cent, respectively). Level IV metastasis was found in 6.25 per cent of patients.

Conclusion:

Supraomohyoid neck dissection appears to be an appropriate treatment for N0 tongue squamous cell carcinoma and there is no need for level IV lymph node dissection in a N0 patient.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Mishra, P, Sharma, AK. A 3-year study of supraomohyoid neck dissection and modified radical neck dissection type I in oral cancer: with special reference to involvement of level IV node metastasis. Eur Arch Otorhinolaryngol 2010;267:933–8Google Scholar
2 Wein RO, Malone JP, Weber RS. Malignant neoplasms of the oral cavity. In: Flint, PW, Cummings, CW. Cummings Otolaryngology: Head and Neck Surgery, 5th edn. Philadelphia: Mosby/Elsevier, 2010;1293–318Google Scholar
3 Akhtar, S, Ikram, M, Ghaffar, S. Neck involvement in early carcinoma of tongue. Is elective neck dissection warranted? J Pak Med Assoc 2007;57:305–7Google Scholar
4 Byers, RM, Weber, RS, Andrews, T, McGill, D, Kare, R, Wolf, P. Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue. Head Neck 1997;19:1419 Google Scholar
5 Dogan, E, Cetinayak, HO, Sarioglu, S, Erdag, TK, Ikiz, AO. Patterns of cervical lymph node metastases in oral tongue squamous cell carcinoma: implications for elective and therapeutic neck dissection. J Laryngol Otol 2014;128:268–73Google Scholar
6 Khafif, A, Lopez-Garza, JR, Medina, JE. Is dissection of level IV necessary in patients with T1-T3 N0 tongue cancer? Laryngoscope 2001;111:1088–90Google Scholar
7 Nithya, C, Pandey, M, Naik, B, Ahamed, IM. Patterns of cervical metastasis from carcinoma of the oral tongue. World J Surg Oncol 2003;1:10 CrossRefGoogle ScholarPubMed
8 Woolgar, JA. Pathology of the N0 neck. Br J Oral Maxillofac Surg 1999;37:205–9Google Scholar
9 Crean, SJ, Hoffman, A, Potts, J, Fardy, MJ. Reduction of occult metastatic disease by extension of the supraomohyoid neck dissection to include level IV. Head Neck 2003;25:758–62CrossRefGoogle ScholarPubMed
10 Feng, Z, Li, JN, Niu, LX, Guo, CB. Supraomohyoid neck dissection in the management of oral squamous cell carcinoma: special consideration for skip metastases at level IV or V. J Oral Maxillofac Surg 2014;72:1203–11Google Scholar
11 Guo, CB, Feng, Z, Zhang, JG, Peng, X, Cai, ZG, Mao, C et al. Supraomohyoid neck dissection and modified radical neck dissection for clinically node-negative oral squamous cell carcinoma: a prospective study of prognosis, complications and quality of life. J Craniomaxillofac Surg 2014;42:1885–90Google Scholar