Occult Cervical Metastasis in Head and Neck Cancer and its Impact on Therapy

Wong, Richard J.; Rinaldo, Alessandra; Ferlito, Alfio; Shah, Jatin P.

doi:10.1080/00016480252775832

Cited by 25 publications

(13 citation statements)

References 53 publications

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“…The high risk of occult nodal metastases in oral cavity tumours warrants an attention to the treatment of the neck [10,11]. The extent of elective and therapeutic neck dissections still however remains a contentious issue [12,13].The major morbidity circumvented in modified neck dissections is the preservation of spinal accessory nerve function.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

Dabholkar

Kapre

2015

Indian J Surg Oncol

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“…Die statische Szintigraphie ermöglicht eine genauere Festsetzung des Bereichs des/der Sentinel-Lymphknoten(s), während das intraoperativ applizierte Methylenblau die rasche Identifizierung der Sentinel-Lymphknoten ermöglicht. Da Methylenblau kostengünstiger und bedenkenlos hinsichtlich [31]. Die Palpation und Sonographie allein sind unzureichende Untersuchungen, um auf die elektive Dissektion am Hals verzichten zu können.…”

Section: Diskussionunclassified

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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“…Oral cancer is the sixth most common cancer worldwide, and is the most frequently observed head and neck cancer in South-East Asia [1]. Among the ranks of cancer-related deaths in Taiwan, oral cancer ranked the 4th place in men in 2003.…”

Section: Introductionmentioning

confidence: 99%