Analysis of the Role of Selective Neck Dissection in Clinically Node-Positive T3/T4 Oral Cancers.

Autor: Maharaj DD; Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India., Seenivasagam RK; Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, India., Majumdar KS; Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India., Thaduri A; Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India., Panuganti A; Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India., Kaul P; Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India., Kumar JR; Department of General Surgery, All India Institute of Medical Sciences, Mangalagiri, India., Mohammed N; Department of General Surgery, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, India.
Jazyk: angličtina
Zdroj: BioMed research international [Biomed Res Int] 2022 Feb 10; Vol. 2022, pp. 2204745. Date of Electronic Publication: 2022 Feb 10 (Print Publication: 2022).
DOI: 10.1155/2022/2204745
Abstrakt: Introduction: The concept of selective neck dissection (SND) in locally advanced oral cancers is emerging. Contemporary studies support the feasibility of SND in selected node-positive oral cancers with early primaries. Nevertheless, the suitability of SND in clinically node-positive (cN+) oral cancers with advanced primaries (T3/T4) is unknown.
Aim: This study explores if patients with cN+ advanced primaries were suitable candidates for SND by spotting the involved lymph node distribution in various stations of the neck. Secondary objectives were to check if predictive clinicopathological factors for metastases to the neck in general also apply for lymph node metastases to levels IV and V.
Methods: The present retrospective study analysed the distribution of pathologically involved lymph nodes in 134 patients and explored the interrelation of various predictive factors and cervical metastases overall and those specific to levels IV and V.
Results: Level V was involved in 6.7% (6/83) of T4 and none of the T3 primaries. Depth of invasion (DOI), perineural invasion (PNI), and skin invasion were statistically significant predictors for nodal metastases in general on multivariate analysis.
Conclusion: Our analysis supports the option of considering SND, sparing level V in patients with cN+ oral cancers in a subset with T3 primary and nodal stage N2 and below.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2022 Dungala Dileep Maharaj et al.)
Databáze: MEDLINE
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