Extent of neck dissection for patients with clinical N1 oral cancer

• Published in: International journal of clinical oncology Vol. 25; no. 6; pp. 1067 - 1071
• Main Authors: Kakei, Yasumasa, Komatsu, Hirokazu, Minamikawa, Tsutomu, Hasegawa, Takumi, Teshima, Masanori, Shinomiya, Hirotaka, Otsuki, Naoki, Nibu, Ken-ichi, Akashi, Masaya
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.06.2020; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Cancer Research; Dissection; Female; Humans; Lymph; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Neck; Neck Dissection - methods; Neck Dissection - standards; Oncology; Oral cancer; Original; Original Article; Patients; Surgical Oncology; Tongue; Tongue Neoplasms - pathology; Tongue Neoplasms - surgery; Level IV; N1; Oral cancer; Tongue cancer; Level V; Neck dissection; Supraomohyoid neck dissection; Clinical N1
• ISSN: 1341-9625; 1437-7772; 1437-7772
• DOI: 10.1007/s10147-020-01635-8

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.