Level IIb Lymph Nodes Metastasis in Elective Supraomohyoid Neck Dissection for Oral Cavity Squamous Cell Carcinoma: A Molecular‐Based Study

Elsheikh, Mohamed N.; Mahfouz, Magdy E.; Elsheikh, Ehab A.

doi:10.1097/01.mlg.0000176540.33486.c3

Cited by 64 publications

(47 citation statements)

References 21 publications

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“…There was no instance of isolated or contralateral metastases at level IIb. This was in accordance with results of other authors [15,16,17] . Palleri et al in their prospective study of 50 patients found a positivity at level IIb in 3.9 % oral cavity cancers with contralateral (0.9 %) and isolated (0.3 %) metastases being extremely rare.…”

Section: Discussionsupporting

confidence: 83%

Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?

Dabholkar

Kapre

2015

Indian J Surg Oncol

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Nodal metastases is the most important prognostic marker for oral cavity cancers. Nodal dissection at level IIb risks damage to the spinal accessory nerve. We aim to study positivity of level IIb lymph nodes in oral cancers. In this non-randomized prospective observational study, 65 patients of oral cavity cancers were evaluated. Appropriate surgery for primary tumour and neck dissection were undertaken. All patients underwent level II b dissection. Out of 67 neck dissections (27 elective and 40 therapeutic), 7 patients had level IIb positive for metastases (10.44 %) with no isolated or contralateral metastases at level IIb and direct correlation with level IIa nodes. There was no statistical association of level IIb positivity with stage or site of primary. Level IIb dissection can be avoided in N0 necks. For therapeutic neck dissections, Level IIb should be cleared if there are positive nodes at level IIa.

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Section: Discussionsupporting

confidence: 83%

Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?

Dabholkar

Kapre

2015

Indian J Surg Oncol

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“…It has been demonstrated that isolated level IIB metastases from oral cavity cancers are exteremely rare (Lea, 2010). But, when other levels, especially level IIA, contain occult metastases, level IIB metastases may occur in up to 22% of the patients (Elsheikh, 2005, Lea, 2010. Interestingly, level IIB metastases are almost always seen in patients with tongue cancer, however other oral cavity primary sites only rarely give rise to level IIB metastases (Elsheikh, 2005, Lea, 2010.…”

Section: Extent Of Surgical Removal For Selective Neck Dissectionmentioning

confidence: 99%

“…But, when other levels, especially level IIA, contain occult metastases, level IIB metastases may occur in up to 22% of the patients (Elsheikh, 2005, Lea, 2010. Interestingly, level IIB metastases are almost always seen in patients with tongue cancer, however other oral cavity primary sites only rarely give rise to level IIB metastases (Elsheikh, 2005, Lea, 2010. When the lesion is located in the retromolar trigone with extension to the anterior pillar, level IIB should be dissected (Ayad, 2009).…”

Section: Extent Of Surgical Removal For Selective Neck Dissectionmentioning

confidence: 99%

Current Concept of Selective Nek Dissection

Çoşkun¹

2012

Neck Dissection - Clinical Application and Recent Advances

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“…Initially, this procedure was used in necks with no metastatic lymph nodes (cN0) and in those cases with lymph node metastases up to 2 cm with no rupture of the capsule (pN1). [9][10][11][12][13][14][15][16][17] These studies underlined our proposition to change the extension of neck dissection for the surgical treatment of necks with clinical metastases (cN1) from squamous cell carcinoma in the lower region of the mouth. We based our proposition on the follow-up of patients and the diagnosis of lymph node recurrence in those anatomical regions not included in the selective procedure.…”

Section: Introductionmentioning

confidence: 99%

Esvaziamento radical versus seletivo (supraomohióideo) no tratamento do carcinoma epidermóide do andar inferior da boca

Rapoport

Ortellado

Amar

et al. 2007

Rev. Bras. Otorrinolaringol.

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The therapeutic paradigm for neck metastasis of squamous cell carcinoma (SCC) in the lower level of the mouth has changed due to survival. Aim: A comparative study between radical (RND) versus selective neck dissection (SND). In the RND the metastathic rate in levels IV and V was assessed; in the SND the presence and site of recurrence was identified. The chi square test with the Yates correction was the chosen statistical method. Results: In the RND the metastatic rates were 5.8% (level IV) and 4.6% (level V) for cNO cases, and 9.9% (level IV) and 5.9%(level V) for cN+ cases; for level I only the rates were 11,0% for cNO cases and 5.5% for cN+ cases. In the SND the number of recurrences was 4 (4.1%) in 97 neck dissections (pNO) and 2 (10%) in 20 neck dissections (pN+). There was no advantage in using radiation compared to non-irradiated cases (5.6% and 5.7%). Conclusion: The SND may be used for SCC of the lower level of the mouth.

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Level IIb Lymph Nodes Metastasis in Elective Supraomohyoid Neck Dissection for Oral Cavity Squamous Cell Carcinoma: A Molecular‐Based Study

Abstract: In this study, level IIb lymph node metastasis was only found in association with tongue carcinoma. Although this region may be preserved in elective SOHND in patients with SCC of the oral cavity, it should be included whenever the tongue is the primary site.

Cited by 64 publications

References 21 publications

Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?

Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?

Current Concept of Selective Nek Dissection

Esvaziamento radical versus seletivo (supraomohióideo) no tratamento do carcinoma epidermóide do andar inferior da boca

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