Neck Dissection: An Operation in Evolution

Myers, Eugene N.; Gastman, Brian

doi:10.1001/archotol.129.1.14

Cited by 44 publications

(25 citation statements)

References 110 publications

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“…13 However, the use of SND as a therapeutic procedure for SCC in the tongue and the floor of the mouth, especially when comparing the effectiveness based on oncologic outcomes after CND, remains controversial in the current literature. The concept that was adopted in the management of positive necks was CND, and SND was not advocated in patients with advanced nodal disease or in a salvage setting.…”

Section: Discussionmentioning

confidence: 99%

Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma

Feng

Gao

Niu

et al. 2014

International Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma

Feng

Gao

Niu

et al. 2014

International Journal of Oral and Maxillofacial Surgery

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“…Ein deutlicher Übergang von klassischer radikaler "neck dissection" (RND), bei der alle lymphatischen Strukturen der fünf Halsregionen mitsamt Musculus sternokleidomastoideus, der Vena jugularis und Nervus accessorius aentfernt, zu den immer modifizierteren Dissektionen, bei denen nur Lymphknoten einzelner Halsregionen entfernt werden, während andere bedeutende Strukturen erhalten bleiben und schließlich bis zur selektiven Ausräumung einzelner Regionen. Die selektivste Dissektion würde die Exstirpation lediglich der Sentinel-Lymphknoten darstellen [12]. Das Konzept des Sentinels (Wächter-Lymphknoten) basiert auf der Annahme, dass der Karzinomthrombus zuerst jenen Lymphknoten passieren muss, zu dem die Lymphe aus dem Tumorbereich drainiert wird.…”

Section: Introductionunclassified

Sentinel-Lymphknoten bei oralen und oropharyngealen epithelialen Tumoren

Čizmarevič

Žargi²

2006

Wien Klin Wochenschr

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Carcinomatous metastases in regional lymph nodes worsen substantially the prognosis of patients with oral cavity and oropharyngeal cancer. Due to the high probability of occult metastasis (about 30%), during surgical resection of the primary tumor usually also elective dissection of lymph nodes is performed. Opinions on the extent of the elective neck dissection still differ, whereas selective dissection increasingly gains in importance. The aim of selective dissections, based on the predictability of formation of metastases, is the identification and exstirpation of the sentinel lymph node. In this prospective study the applicability of the concept of the sentinel lymph node in patients with oral cavity and oropharyngeal cancer was analysed. 12 patients with oral cavity and orophangeal cancer, staging T1-T3, all N0 (examined by palpation and sonography) were included. The localization of the sentinel(s) was determined preoperatively by radioisotope (Tc Nanocolloid). Sentinel(s) were identified first with a gamma probe (Neoprobe 2000); we then injected methylene blue into the peritumoral area for easier detection of the sentinel(s). The sentinels were removed and sent for frozen section examination. Regardless of the findings of the frozen section examination modified dissection was carried out. Later we compared frozen sections with paraffin microtome sections of sentinel(s) and of other exstirpated neck lymph nodes. We could identify the sentinel lymph node in all patients, in 6/12 patients we found several sentinels. If sentinels were not affected by tumor cells, there were no metastases in the downstream neck lymph nodes either. If in the sentinel lymph nodes no metastases can be determined, eliminating the environment alone could be sufficient. However, this assumption requires verification in a larger patient group.

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“…This factor is in itself a contraindication for SND in cases of N+ necks, even with the presence of limited metastasis. 2,3,[9][10][11][12][13]15,22,[25][26][27][28][29] Because of the limited number of patients in this study, we were not able to correlate the presence of capsule rupture with a greater chance of neck recurrence or negative patient evolution. Nonetheless, from the data presented in the literature and from our data, the use of SND does not seem to be prudent in cases with signs of intraoperative capsule rupture or in the event that frozen-section biopsy confirms the case.…”

Section: Resultsmentioning

confidence: 99%

“…This technique was defended and reiterated by Hayes Martin. 8,9 Currently, radical neck dissection is practically restricted to patients presenting fixed metastases with capsule rupture or in whom exposure of the nonlymphatic structures is evident, along with cases with local tumor recurrence.…”

Section: Introductionmentioning

confidence: 99%

Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract

Antonio¹,

Menezes²,

Kavabata³

et al. 2008

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Modified radical neck dissection (MRND) is the classical treatment for neck metastases of squamous cell carcinoma (SCC) of the upper aerodigestive tract. However, it may still be accompanied by significant sequelae. One alternative for this treatment would be selective neck dissection (SND), which has a lower incidence of sequelae. The aim of this study was to define which neck metastasis cases would really be suitable candidates for SND. DESIGN AND SETTING: Retrospective clinical-surgical trial at the Division of Head and Neck Surgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP). METHODS: We retrospectively studied 67 patients with SCC of the upper aerodigestive tract, divided into two groups: 1) 47 patients treated by means of SND (node-negative or node-positive), 2) 20 patients treated by means of MRND (all node-positive). RESULTS: Our results demonstrated that there was no difference between the patients treated with SND or MRND in relation to disease evolution, and that the main prognostic factor was lymph node involvement. We observed that patients with pharyngeal SCC and older patients presented worse evolution and would probably not be suitable candidates for SND. CONCLUSIONS: SND may be a good option for treating node-positive necks in selected cases.

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Neck Dissection: An Operation in Evolution

Cited by 44 publications

References 110 publications

Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma

Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma

Sentinel-Lymphknoten bei oralen und oropharyngealen epithelialen Tumoren

Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract

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