A Clinical Comparison of the Efficacy of Level I-III Versus Level I-IV Neck Dissection in N0 Early Stage Tongue Squamous Cell Carcinoma
-
Maziar Motiee-Langroudi
,
Hamed Emami
,
Keyvan Aghazadeh
,
Mehrdad Jafari
,
Khashayar Afshari
,
Sahand Kia
,
Siamak Salahi
,
Armin Akbari
Abstract
In this study, we compared regional recurrence in patients who had a dissection of levels I-III or levels I-IV. Patients with tongue SCC who were node-negative both clinically and radiologically, and underwent elective supraomohyoid neck dissection (SOHND) or extended supraomohyoid neck dissection (ESOHND) between March 2012, and March 2015 were retrospectively reviewed. The two therapeutic groups were analyzed for the incidence of tumor recurrence and survival. The two groups had statistically similar demographic qualities. Surgery duration and complications were the same in both groups. Complications mainly included internal jugular vein and thoracic duct injury. Tumour size was 46.2% T1, 40.4 % T2, and 13.3% Tx, being statistically similar in both groups. Tumour size had no meaningful correlation with the occurrence of occult neck metastasis in both groups. Local recurrence was more in ESOHND patients, but regional recurrence was similar in both groups. The survival rate was alike in both groups. No significant differences in tumor recurrence and mortality rate were found between patients treated with SOHND versus ESOHND. Thus, SOHND could be considered as a sufficient treatment for early-stage tongue SCC.
1. Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, et al. Cummings otolaryngology-head and neck surgery. Netherlands: Elsevier Health Sciences, 2014.
2. Hoffman HT, Karnell LH, Funk GF, Robinson RA, Menck HR. The National Cancer Data Base report on cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124:951-62.
3. Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head neck 2002;24:165-80.
4. Sung K-W, Kim SM, Myoung H, Kim M-J, Lee J-H. The effectiveness of elective neck dissection on early (stage I, II) squamous cell carcinoma of the oral tongue. J Korean Assoc Oral Maxillofac Surg 2017;43:147-51.
5. Choi W, Han F. Is prophylactic neck dissection for early tongue squamous cell carcinoma (cT1-2, cN0 neck) an evidence-based choice? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017;46:282.
6. Byers RM, Weber RS, Andrews T, McGill D, Kare R, Wolf P. Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue. Head Neck 1997;19:14-9.
7. Network NCC. NCCN clinical practice guidelines in oncology: head and neck cancers, V. 2.20082008. (Accessed, 2008 at https://www.nccn.org/professionals/physician_gls/default.aspx#site.)
8. Akhtar S. Neck involvement in early carcinoma of tongue. Is elective neck dissection warranted? J Pak Med Assoc 2007;57:305.
9. Motiee-Langroudi M, Amali A, Saedi B, H Emami, F Ensani, A Lotfi, et al. Occult level IV metastases in clinically node-negative patients with oral tongue squamous cell carcinoma. J Laryngol Otol 2016;130:474-7.
10. Iype EM, Sebastian P, Mathew A, Balagopal P, Varghese BT, Thomas S. The role of selective neck dissection (I–III) in the treatment of node negative (N0) neck in oral cancer. Oral Oncol 2008;44:1134-8.
11. Yu S, Li J, Li Z, Zhang W, Zhao J. Efficacy of supraomohyoid neck dissection in patients with oral squamous cell carcinoma and negative neck. Am J Surg 2006;191:94-9.
12. Guo CB, Feng Z, Zhang JG, Peng X, Cai Zh G, Mao Ch, et al. Supraomohyoid neck dissection and modified radical neck dissection for clinically node-negative oral squamous cell carcinoma: a prospective study of prognosis, complications and quality of life. J Craniomaxillofac Surg 2014;42:1885-90.
13. Shen Z-s, Li J-s, Chen W-l, Fan S. The Latest Advancements in Selective Neck Dissection for Early Stage Oral Squamous Cell Carcinoma. Curr Treat Options Oncol 2017;18:31.
14. Möckelmann N, Lörincz BB, Knecht R. Robotic-assisted selective and modified radical neck dissection in head and neck cancer patients. Int J Surg 2016;25:24-30.
15. Tadiparthi S, Enache A, Kalidindi K, O'hara J, Paleri V. Hospital stay following complex major head and neck resection: what factors play a role? Clin Otolaryngol 2014;39:156-163.
16. Halawani HM, Bakkar S, Jamali SF, Khalifeh F, Saad GA. Life threatening presentation of thoracic duct injury post thyroid surgery; a case report. Int j surg case rep 2017;34:40-42.
17. Delaney SW, Shi H, Shokrani A, Sinha UK. Management of chyle leak after head and neck surgery: review of current treatment strategies. Int J Otolaryngol 2017;2017:8362874.
18. Masud M, Ahmad S, Karim M, F Ferdouse, A Y Fakir, M A Hanif, et al. Complications of neck dissection at a
tertiary level hospital: study of 30 cases. Mymensingh Med J 2014;23:658-66.
19. Brown DH, Mulholland S, Yoo JH, P J Gullane, J C Irish, P Neligan, et al. Internal jugular vein thrombosis following modified neck dissection: implications for head and neck flap reconstruction. Head neck. 1998;20:169-74.
20. Teymoortash A, Hoch S, Eivazi B, Werner JA. Postoperative morbidity after different types of selective neck dissection. Laryngoscope 2010;120:924-929.
21. Mücke T, Mitchell DA, Wagenpfeil S, Ritschl LM, Wolff K-D, Kanatas A. Incidence and outcome for patients with occult lymph node involvement in T1 and T2 oral squamous cell carcinoma: a prospective study. BMC cancer 2014;14:346.
22. Mantsopoulos K, Psychogios G, Künzel J, Waldfahrer F, Zenk J, Iro H. Primary surgical therapy for locally limited oral tongue cancer. BioMed res int 2014;2014:738716.
23. Sharma P, Shah S, Taneja C, Patel AM, Patel MD. A prospective study of prognostic factors for recurrence in early oral tongue cancer. J Clin Diagn Res 2013;7:2559.
24. Vijayakumar M, Burrah R, Sabitha K, Nadimul H, Rajani B. To operate or not to operate N0 neck in early cancer of the tongue? A prospective study. Indian J Surg Oncol 2011;2:172-5.
25. Moreno-García C. Elective neck dissection in early oral squamous cell carcinoma: Necessary. Plast Aesthet Res 2016;3:167-74.
26. Jerjes W, Upile T, Petrie A, Riskalla A, Hamdoon Z, Vourvachis M, et al. Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients. Head Neck Onco. 2010;2:9.
27. Kligerman J, Lima RA, Soares JR, L Prado, F L Dias, E Q Freitas, et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. Am j surg 1994;168:391-4.
28. Rani P, Bhardwaj Y, Dass PK, Gupta M, Malhotra D, Ghezta NK. Neck dissection for oral squamous cell carcinoma: our experience and a review of the literature. J Korean Assoc Oral Maxillofac Surg 2015;41:299-305.
2. Hoffman HT, Karnell LH, Funk GF, Robinson RA, Menck HR. The National Cancer Data Base report on cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124:951-62.
3. Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head neck 2002;24:165-80.
4. Sung K-W, Kim SM, Myoung H, Kim M-J, Lee J-H. The effectiveness of elective neck dissection on early (stage I, II) squamous cell carcinoma of the oral tongue. J Korean Assoc Oral Maxillofac Surg 2017;43:147-51.
5. Choi W, Han F. Is prophylactic neck dissection for early tongue squamous cell carcinoma (cT1-2, cN0 neck) an evidence-based choice? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017;46:282.
6. Byers RM, Weber RS, Andrews T, McGill D, Kare R, Wolf P. Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue. Head Neck 1997;19:14-9.
7. Network NCC. NCCN clinical practice guidelines in oncology: head and neck cancers, V. 2.20082008. (Accessed, 2008 at https://www.nccn.org/professionals/physician_gls/default.aspx#site.)
8. Akhtar S. Neck involvement in early carcinoma of tongue. Is elective neck dissection warranted? J Pak Med Assoc 2007;57:305.
9. Motiee-Langroudi M, Amali A, Saedi B, H Emami, F Ensani, A Lotfi, et al. Occult level IV metastases in clinically node-negative patients with oral tongue squamous cell carcinoma. J Laryngol Otol 2016;130:474-7.
10. Iype EM, Sebastian P, Mathew A, Balagopal P, Varghese BT, Thomas S. The role of selective neck dissection (I–III) in the treatment of node negative (N0) neck in oral cancer. Oral Oncol 2008;44:1134-8.
11. Yu S, Li J, Li Z, Zhang W, Zhao J. Efficacy of supraomohyoid neck dissection in patients with oral squamous cell carcinoma and negative neck. Am J Surg 2006;191:94-9.
12. Guo CB, Feng Z, Zhang JG, Peng X, Cai Zh G, Mao Ch, et al. Supraomohyoid neck dissection and modified radical neck dissection for clinically node-negative oral squamous cell carcinoma: a prospective study of prognosis, complications and quality of life. J Craniomaxillofac Surg 2014;42:1885-90.
13. Shen Z-s, Li J-s, Chen W-l, Fan S. The Latest Advancements in Selective Neck Dissection for Early Stage Oral Squamous Cell Carcinoma. Curr Treat Options Oncol 2017;18:31.
14. Möckelmann N, Lörincz BB, Knecht R. Robotic-assisted selective and modified radical neck dissection in head and neck cancer patients. Int J Surg 2016;25:24-30.
15. Tadiparthi S, Enache A, Kalidindi K, O'hara J, Paleri V. Hospital stay following complex major head and neck resection: what factors play a role? Clin Otolaryngol 2014;39:156-163.
16. Halawani HM, Bakkar S, Jamali SF, Khalifeh F, Saad GA. Life threatening presentation of thoracic duct injury post thyroid surgery; a case report. Int j surg case rep 2017;34:40-42.
17. Delaney SW, Shi H, Shokrani A, Sinha UK. Management of chyle leak after head and neck surgery: review of current treatment strategies. Int J Otolaryngol 2017;2017:8362874.
18. Masud M, Ahmad S, Karim M, F Ferdouse, A Y Fakir, M A Hanif, et al. Complications of neck dissection at a
tertiary level hospital: study of 30 cases. Mymensingh Med J 2014;23:658-66.
19. Brown DH, Mulholland S, Yoo JH, P J Gullane, J C Irish, P Neligan, et al. Internal jugular vein thrombosis following modified neck dissection: implications for head and neck flap reconstruction. Head neck. 1998;20:169-74.
20. Teymoortash A, Hoch S, Eivazi B, Werner JA. Postoperative morbidity after different types of selective neck dissection. Laryngoscope 2010;120:924-929.
21. Mücke T, Mitchell DA, Wagenpfeil S, Ritschl LM, Wolff K-D, Kanatas A. Incidence and outcome for patients with occult lymph node involvement in T1 and T2 oral squamous cell carcinoma: a prospective study. BMC cancer 2014;14:346.
22. Mantsopoulos K, Psychogios G, Künzel J, Waldfahrer F, Zenk J, Iro H. Primary surgical therapy for locally limited oral tongue cancer. BioMed res int 2014;2014:738716.
23. Sharma P, Shah S, Taneja C, Patel AM, Patel MD. A prospective study of prognostic factors for recurrence in early oral tongue cancer. J Clin Diagn Res 2013;7:2559.
24. Vijayakumar M, Burrah R, Sabitha K, Nadimul H, Rajani B. To operate or not to operate N0 neck in early cancer of the tongue? A prospective study. Indian J Surg Oncol 2011;2:172-5.
25. Moreno-García C. Elective neck dissection in early oral squamous cell carcinoma: Necessary. Plast Aesthet Res 2016;3:167-74.
26. Jerjes W, Upile T, Petrie A, Riskalla A, Hamdoon Z, Vourvachis M, et al. Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients. Head Neck Onco. 2010;2:9.
27. Kligerman J, Lima RA, Soares JR, L Prado, F L Dias, E Q Freitas, et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. Am j surg 1994;168:391-4.
28. Rani P, Bhardwaj Y, Dass PK, Gupta M, Malhotra D, Ghezta NK. Neck dissection for oral squamous cell carcinoma: our experience and a review of the literature. J Korean Assoc Oral Maxillofac Surg 2015;41:299-305.
| Files | ||
| Issue | Vol 58, No 2 (2020) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/acta.v58i2.3716 | |
| Keywords | ||
| Neck dissection Tongue Squamous cell carcinoma Tumor recurrence Mortality rate | ||
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How to Cite
1.
Motiee-Langroudi M, Emami H, Aghazadeh K, Jafari M, Afshari K, Kia S, Salahi S, Akbari A. A Clinical Comparison of the Efficacy of Level I-III Versus Level I-IV Neck Dissection in N0 Early Stage Tongue Squamous Cell Carcinoma. Acta Med Iran. 2020;58(2):85-90.
