A Clinical Comparison of the Efficacy of Level I-III Versus Level I-IV Neck Dissection in N0 Early Stage Tongue Squamous Cell Carcinoma

In this study, we compared regional recurrence in patients who had a dissection of levels I-III or levels I-IV. Patients with tongue SCC who were node-negative both clinically and radiologically, and underwent elective supraomohyoid neck dissection (SOHND) or extended supraomohyoid neck dissection (ESOHND) between March 2012, and March 2015 were retrospectively reviewed. The two therapeutic groups were analyzed for the incidence of tumor recurrence and survival. The two groups had statistically similar demographic qualities. Surgery duration and complications were the same in both groups. Complications mainly included internal jugular vein and thoracic duct injury. Tumour size was 46.2% T1, 40.4 % T2, and 13.3% Tx, being statistically similar in both groups. Tumour size had no meaningful correlation with the occurrence of occult neck metastasis in both groups. Local recurrence was more in ESOHND patients, but regional recurrence was similar in both groups. The survival rate was alike in both groups. No significant differences in tumor recurrence and mortality rate were found between patients treated with SOHND versus ESOHND. Thus, SOHND could be considered as a sufficient treatment for early-stage tongue SCC.

[1]  Jong-Ho Lee,et al.  The effectiveness of elective neck dissection on early (stage I, II) squamous cell carcinoma of the oral tongue , 2017, Journal of the Korean Association of Oral and Maxillofacial Surgeons.

[2]  S. Fan,et al.  The Latest Advancements in Selective Neck Dissection for Early Stage Oral Squamous Cell Carcinoma , 2017, Current Treatment Options in Oncology.

[3]  Sarah Jamali,et al.  Life threatening presentation of thoracic duct injury post thyroid surgery; a case report , 2017, International journal of surgery case reports.

[4]  W. Choi,et al.  Is prophylactic neck dissection for early tongue squamous cell carcinoma (cT1-2, cN0 neck) an evidence-based choice? A systematic review and meta-analysis , 2017 .

[5]  U. Sinha,et al.  Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies , 2017, International journal of otolaryngology.

[6]  C. Moreno-García,et al.  Elective neck dissection in early oral squamous cell carcinoma: necessary? , 2016 .

[7]  H. Emami,et al.  Occult level IV metastases in clinically node-negative patients with oral tongue squamous cell carcinoma , 2016, The Journal of Laryngology & Otology.

[8]  Manoj Gupta,et al.  Neck dissection for oral squamous cell carcinoma: our experience and a review of the literature , 2015, Journal of the Korean Association of Oral and Maxillofacial Surgeons.

[9]  Guang-Yan Yu,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. , 2014, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[10]  S. Ahmad,et al.  Complications of neck dissection at a tertiary level hospital: study of 30 cases. , 2014, Mymensingh medical journal : MMJ.

[11]  K. Kalidindi,et al.  Hospital stay following complex major head and neck resection: what factors play a role? , 2014, Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery.

[12]  G. Psychogios,et al.  Primary Surgical Therapy for Locally Limited Oral Tongue Cancer , 2014, BioMed research international.

[13]  T. Mücke,et al.  Incidence and outcome for patients with occult lymph node involvement in T1 and T2 oral squamous cell carcinoma: a prospective study , 2014, BMC Cancer.

[14]  Mahesh D. Patel,et al.  A prospective study of prognostic factors for recurrence in early oral tongue cancer. , 2013, Journal of clinical and diagnostic research : JCDR.

[15]  M. Vijayakumar,et al.  To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study , 2011, Indian journal of surgical oncology.

[16]  Mark A. Zacharek,et al.  Cummings Otolaryngology: Head and Neck Surgery , 2011 .

[17]  J. Werner,et al.  Postoperative morbidity after different types of selective neck dissection , 2010, The Laryngoscope.

[18]  A. Petrie,et al.  Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients , 2010, Head & neck oncology.

[19]  Shaji Thomas,et al.  The role of selective neck dissection (I-III) in the treatment of node negative (N0) neck in oral cancer. , 2008, Oral oncology.

[20]  M. Ikram,et al.  Neck involvement in early carcinoma of tongue. Is elective neck dissection warranted? , 2007, JPMA. The Journal of the Pakistan Medical Association.

[21]  D. Trask,et al.  Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. , 2002, Head & neck.

[22]  G. Funk,et al.  The National Cancer Data Base report on cancer of the head and neck. , 1998, Archives of otolaryngology--head & neck surgery.

[23]  P. Gullane,et al.  Internal jugular vein thrombosis following modified neck dissection: implications for head and neck flap reconstruction , 1998, Head & neck.

[24]  R. Lima,et al.  Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. , 1994, American journal of surgery.

[25]  Chad A. LaGrange,et al.  NCCN CLINICAL PRACTICE GUIDELINES IN ONCOLOGY , 2019 .

[26]  R. Knecht,et al.  Robotic-assisted selective and modified radical neck dissection in head and neck cancer patients. , 2016, International journal of surgery.

[27]  Zubing Li,et al.  Efficacy of supraomohyoid neck dissection in patients with oral squamous cell carcinoma and negative neck. , 2006, American journal of surgery.

[28]  J. Manni.  Frequency and therapeutic implications of "skip metastases" in the neck from squamous carcinoma of the oral tongue. , 1997, Head & neck.