The effectiveness of elective neck dissection on early (stage I, II) squamous cell carcinoma of the oral tongue

OBJECTIVES: The purpose of this study was to evaluate and compare the treatment outcomes of partial glossectomy with or without elective neck dissection in patients with tongue squamous cell carcinoma (SCCa). MATERIALS AND METHODS: A total of 98 patients who were diagnosed with tongue SCCa and underwent partial glossectomy between 2005 and 2014 were evaluated. Only 14 patients received elective neck dissection, and 84 patients received only partial glossectomy. RESULTS: There were 56 men and 42 women with a mean age of 57 years and mean follow-up period of 33.7 months. There were 70 patients graded as T1 and 28 as T2. The total occult metastasis rate was 17.3%. The 5-year overall survival rate was 83.3% with elective neck dissection and 92.4% with observation. The 5-year disease-free survival rate was in 70.7% in the elective neck dissection group and 65.3% in the observation group. CONCLUSION: We retrospectively reviewed the records of 98 patients with tongue SCCa. These patients were divided into two groups, those who underwent elective neck dissection and those who did not. There was no statistically significant difference between the groups undergoing partial glossectomy with or without elective neck dissection.

Experience of the Elective Neck Dissection in Clinical N0 Neck / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The status of cervical lymph node is a great influence to the prognosis of patient with head and neck cancer. There has been a great controversies on the treatment of clinical N0 neck. The purpose of this study is to analyze the outcomes of the elective neck dissection in clinical N0 neck of various sites of primary lesion. MATERIALS AND METHODS: The authors analyzed the outcomes of elective neck dissection by retrospective study with review of records of 38 head and neck cancer patients (56 sites) who had clinically N0 neck. RESULTS: The overall rate of occult neck metastasis was 31.6%. Occult neck metastasis rates according to primary sites were 37.5% (supraglottic larynx), 25.0% (glottis), 25.0% (hypopharynx) and 20. 0% (tongue) and according to T stage were 50,0% (T1), 13.3% (T2), 57.1% (T3) and 0% (T4). Four cases had nodal recurrence (1 out of 4 had occult neck metastasis) after elective neck dissections and there were no significant postoperative complications. CONCLUSION: Due to relatively high overall occult neck metastasis rate, and no significant postoperative complications, the elective neck dissection should be considered against potential possibility of occult neck metastasis in the primary sites and extent of head and neck cancers.

Occult Neck Metastasis in Larynx and Hypopharynx Squamous Cell Carcinomas Confirmed with Simultaneous Bilateral Elective Neck Dissection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Neck metastasis is one of the most important prognostic factor in treating head and neck squamous cell carcinomas. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. However, occult metastasis rate confirmed with simultaneous bilateral elective dissection is rare. MATERIALS AND METHODS: Fifty patients (100 necks) who underwent surgery for laryngeal and hypopharyngeal squamous cell carcinomas as an initial treatment from 1992 to 1997 were evaluated. All had bilateral elective neck dissection at the time of surgery for the primary treatment. Charts and pathologic reports were reviewed. RESULT: Occult neck metastasis rate by primary site were as follows. Supraglottis ipsilateral 40% (8/20) contralateral 15% (3/20), glottis ipsilateral 18% (4/22), contralateral 0% (0/22), hypopharynx ipsilateral 88% (7/8), contralateral 25% (2/8). CONCLUSION: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Contralateral neck occult metastasis from glottic cancer was minimal.