OP189

Autor: Dipayan Nandy, Yogen P. Chheda, Sundaram Kaliappan Pillai, Shakuntala Viren Shah
Rok vydání: 2013
Předmět:
Zdroj: Oral Oncology. 49:S75
ISSN: 1368-8375
DOI: 10.1016/j.oraloncology.2013.03.197
Popis: Objectives Level IIB lymph node dissection is known to be associated with tractional spinal accessory nerve injury resulting in shoulder dysfunction. The purpose of this study is to analyze the extent of level IIB node involvement in patients with oral cavity SCC who underwent primary surgery with functional neck dissection. Study design Prospective Methods and materials A prospective study of 175 patients of oral SCC admitted to a tertiary care centre during period from January 2011 to July 2012 was conducted. During neck dissection, level IIB lymph nodes were dissected, labelled, and processed separately from the remainder of functional neck dissection specimen. We studied the incidence of histopathological metastasis to level IIB nodes in cN0 (clinically node negative) patients. Results Of 175 cases of cN0 neck, 80% were pN0. Out of remaining 20% pN+, 66% showed evidence of level IB nodal involvement. Only 2 patients showed evidence of level IIB node involvement (1.14%). This was associated with simultaneous involvement of level IIA. There was no evidence of isolated level IIb lymph node involvement in clinically N0 disease. Conclusion Isolated level IIB nodal involvement is rare in patients of oral SCC with cN0 neck. It is almost always associated with simultaneous level IIA involvement. To improve the functional outcome of spinal accessory nerve, level IIB lymph node dissection may be avoided in cN0 patients. We recommend frozen section of level IIa node to safely avoid level IIb dissection if the frozen is negative for metastatic disease at level IIa.
Databáze: OpenAIRE
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