Extent of lymph node dissection in T3/T4 cancer of the alveolo-buccal complex

✍ Scribed by Dr. Raja S. Rao; Vinay H. Deshmane; Hemen K. Parikh; Deepak M. Parikh; Pinni S. Sukthankar

• Book ID: 102235360
• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 460 KB
• Volume: 17
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.2880170306

✦ Synopsis

Background. Cancer of the alveolo-buccal complex even when locally advanced is amenable to curative resection. However, the extent of lymph node dissection remains controversial.

Methods. A total of 181 patients with T3iT4 cancer of the alveolo-buccal complex who underwent a radical neck dissection (RND) were analyzed retrospectively to determine the incidence and pattern of lymph node involvement and to define the extent of neck dissection required in these cancers.

Results. Lymph node involvement was as follows: level I (85%), II (51%), 111 (19%), IV (18%), V (5%). Levels I and II were most commonly involved (94%). Skip metastases occurred in 13%. Levels IV and V were involved in 2% and 20% when levels I, II, and 111 were uninvolved and involved, respectively. Conclusion. A supraomohyoid neck dissection (SOHD) should be performed and subjected to a frozen section evaluation in every patient. If lymph nodes are negative, then SOHD is adequate. If levels I, II, or 111 are positive, then a RND should be performed.