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Patterns of cervical lymph node metastases in oral tongue squamous cell carcinoma: implications for elective and therapeutic neck dissection

Published online by Cambridge University Press:  19 February 2014

E Dogan ,
H O Cetinayak ,
S Sarioglu ,
T K Erdag  and
A O Ikiz
E Dogan*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
H O Cetinayak
Affiliation:
Department of Radiation Oncology, Dokuz Eylul University School of Medicine, Izmir, Turkey
S Sarioglu
Affiliation:
Department of Pathology, Dokuz Eylul University School of Medicine, Izmir, Turkey
T K Erdag
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
A O Ikiz
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey
*
Address for correspondence: Dr E Dogan, Ilica Mah, Akcakir Sokak, Keyif Apt, No. 3/6, 35320, Narlidere, Izmir, Turkey Fax: +90 232 4123269 E-mail: ersoy.dogan@deu.edu.tr
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Abstract

Objectives:

To determine the patterns of lymph node metastases in oral tongue carcinomas, and examine the implications for elective and therapeutic neck dissection.

Method:

The study entailed a retrospective analysis of 67 patients with previously untreated oral tongue squamous cell carcinoma who had undergone simultaneous glossectomy and neck dissection.

Results:

Of the 40 clinically node-negative patients, 7 patients had metastatic lymph nodes on pathological examination. No occult metastasis was found at level IV. Of the 27 clinically node-positive patients, the incidence rate of level IV metastasis was 11.1 per cent (3 out of 27 patients). No ‘skip metastases’ were found at level IV. Level IV metastases were significantly related to clinically staged nodes categorised as over 2a (p = 0.03) and metastasis to level III (p = 0.01).

Conclusion:

Routine inclusion of level IV in elective neck dissection is not necessary for clinically node-negative patients with oral tongue squamous cell carcinoma. Furthermore, extended supraomohyoid neck dissection with adjuvant radiotherapy can be sufficient in the treatment of selected patients with clinically node-positive necks.

Keywords

TongueSquamous Cell CarcinomaNeck DissectionNeoplasm MetastasisPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 3 , March 2014 , pp. 268 - 273
Copyright
Copyright © JLO (1984) Limited 2014 

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