Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck

Agarwal, Sangeet Kumar; Arora, Sowrabh Kumar; Kumar, G. Santhosh; Sarin, Deepak

doi:10.1002/lary.25954

Cited by 21 publications

(15 citation statements)

References 9 publications

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“…With a random effects model, the pooled estimated cervical level IIb metastases rate was 6% (95% CI: 4.0–7.0). When the data in the largest weight 25 were removed, the result was 5% (95% CI: 4.0–6.0), and when the data in the minimum weight 38 were deleted, the result was 5% (95% CI: 4.0–7.0). With a fixed-effects model, the pooled estimated cervical IIb metastases rate for tongue SCC was 7% (95% CI: 5.0–10.0).…”

Section: Resultsmentioning

confidence: 99%

Cervical level IIb metastases in squamous cell carcinoma of the oral cavity: a systematic review and meta-analysis

Kou

Zhao

Huang

et al. 2017

OTT

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PurposeThe aim of this study was to clarify whether level IIb dissection should be performed or avoided in the treatment of oral squamous cell carcinoma by meta-analysis.Materials and methodsArticles that were published before June 2017 were searched electronically in four databases (Web of Science, PubMed, Ovid and China National Knowledge Infrastructure) without any date or language restrictions by two independent reviewers. Abstracts and full-text papers which investigated the cervical metastases to level IIb from primary head and neck cancers and were deemed potentially relevant were screened. Data were analyzed using RevMan 5.3.ResultsFour hundred and fifty-five abstracts and 129 full-text papers were screened, and 22 studies were included in the analysis. Among the 2001 patients included, 112 patients had level IIb metastases, the pooled frequency of which was 6% (95% confidence interval [CI]: 4.0–7.0). Among the 400 patients with tongue squamous cell carcinoma from 12 studies, 37 patients had level IIb metastases, the pooled incidence of which was 7% (95% CI: 5.0–10.0). Metastases to level IIb always went together with level IIa, and only three patients were found to have isolated level IIb metastases without involving the other levels.ConclusionDue to the low frequency of level IIb nodal metastases in oral squamous cell carcinoma patients and rare occurrence of isolated level IIb, level IIb dissection could be avoided when the primary lesions were in early stages (T1 and T2), with the exception of tongue cancer. It is recommended to dissect level IIb tongue cancers without considering the stages of primary lesions and the lymph nodes status. It is also suggested that level IIb dissection should be performed in patients preoperatively or intraoperatively found with multilevel neck metastasis, especially level IIa metastasis.

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Section: Resultsmentioning

confidence: 99%

Cervical level IIb metastases in squamous cell carcinoma of the oral cavity: a systematic review and meta-analysis

Kou

Zhao

Huang

et al. 2017

OTT

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“…However, some of the aforementioned articles suggest removing PFNs, especially in oral carcinomas and even in N0 cases if the cancer involves the tongue or buccal mucosa. 19 In the near future, more substantial studies will be needed to give definitive indications to PFN removal in relation to the primary cancer and the state of the neck. Nevertheless, this would not be possible without precise anatomic knowledge of the PFNs and an accurate description of a surgical technique that provides complete removal of these lymph nodes without damaging the MMN.…”

Section: Discussionmentioning

confidence: 99%

Lymph Nodes of the Perimandibular Area and the Hazard of the Hayes Martin Maneuver in Neck Dissection

Tirelli

Marcuzzo

2018

Otolaryngol.--head neck surg.

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Objective To provide an anatomic description of submandibular nodes at risk of being left undissected during neck dissection (ND) and to assess whether the Hayes Martin maneuver is a safe procedure in oncologic surgery of level IB nodes. Study Design Prospective study. Setting Academic medical center. Subjects and Methods We recruited 62 patients who were candidates for level IB ND. Perifacial nodes (PFNs) were identified and their characteristics noted. The Hayes Martin maneuver was simulated, and its oncologic safety was tested. Results The study included 63 NDs. PFNs were identified in 84% of cases: their number ranged from 0 to 5, and their mean greatest diameter was 12.45 mm. Anterior PFNs were found to be in direct contact with the marginal mandibular nerve. In 59% of NDs, the Hayes Martin maneuver would have failed to remove all PFNs. Conclusions The PFNs were identified in 84% of cases and ranged in number from 0 to 5. In some cases, the distinction between retro- and preglandular nodes and PFNs is not useful. The Hayes Martin maneuver may not be oncologically sound for complete treatment of level IB nodes.

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“…In a report by Lim et al [ 32 ], 41 patients with cN0 tongue SCC underwent 72 neck dissections, and positive perivascular lymph nodes occurred in four (5.6%) of the 72 procedures; 14 patients with cN0 SCC of the floor of the mouth underwent 27 neck dissections, and positive perivascular lymph nodes occurred in two (7.4%) of the 27 procedures. In another study published by Agarwal et al [ 33 ], the authors found that in 231 patients with cN0 oral SCC, the incidence of positive perivascular lymph nodes was 7.1% in tongue SCC and 7.8% in buccal SCC, and the difference was not significant. The perivascular lymph nodes in the abovementioned two studies referred to the prevascular lymph nodes and the retrovascular lymph nodes and were similar to the superior group of lymph nodes in the current study.…”

Section: Discussionmentioning

confidence: 95%

Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and disease-specific survival

Fang

Yao

et al. 2020

BMC Cancer

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Background The feasibility of submandibular gland (SMG) preservation in oral squamous cell carcinoma (SCC) has occasionally been analyzed, but the differences in survival associated with the presence or absence of SMG preservation remain unknown. We aimed to prospectively evaluate the oncologic results of SMG preservation in cT1-2 N0 buccal SCC. Methods This was a prospective, non-randomized cohort study. Patients with surgically treated cT1-2 N0 buccal SCC were prospectively enrolled and divided into two groups based on the management of the SMG. Level 1b lymph nodes were categorized into six groups based on the positional relationship between the lymph node and the SMG. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS). Results A total of 31 of the 137 included patients underwent SMG-sparing neck dissection. Patients with SMG preservation were likely to be young persons. Superior metastasis occurred in 11 patients with a prevalence of 8.0%, followed by an anterior metastasis rate of 5.1%, and no metastases developed deeply or within the SMG. The 5-year LRC rates in the SMG-sparing and SMG-excision groups were 74 and 75%, respectively, and the difference was not significant (p = 0.970). The 5-year DSS rates in the SMG-sparing and SMG-excision groups were 74 and 69%, respectively, and the difference was not significant (p = 0.709). Conclusions SMG involvement was rare, and the superior group carried the highest risk for lymph node metastasis. SMG-sparing neck dissection is selectively suggested in cT1-2 N0 buccal SCC patients, and could avoid postoperative asymmetric appearance and dry mouth.

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Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck

Abstract: 4 Laryngoscope, 126:2252-2256, 2016.

Cited by 21 publications

References 9 publications

Cervical level IIb metastases in squamous cell carcinoma of the oral cavity: a systematic review and meta-analysis

Cervical level IIb metastases in squamous cell carcinoma of the oral cavity: a systematic review and meta-analysis

Lymph Nodes of the Perimandibular Area and the Hazard of the Hayes Martin Maneuver in Neck Dissection

Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and disease-specific survival

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