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Category: Volume 08 Issue 07 July 2020
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Title: Prophylactic neck dissection in cN0 – SCC of Tongue

Authors: K.Pujana, Dr Kaushik Hari MS, Mch (Surg Onco)

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.24

Abstract

Squamous cell carcinoma of tongue has a higher predilection for lymph nodal metastasis(1). Diagnosis of SCC of Tongue is by biopsy from tumor site, cytology from the lymph nodes, laryngoscopy, CT neck, and MRI(2). The management of N0 neck is controversial. The aim of this study is to evaluate the rate and site of occult metastasis and its correlation with characteristics of the primary lesion in tongue. This is a study done over 2 yrs. All patients with anterior 2/3rd of tongue with cN0 are included.

40 cases were included in the study. Occult metastasis are seen in 15 cases (37%), of which 4 cases had multiple levels of nodes metastasis. Extracapsular spread was also seen. Due to the lack of any investigations to find out N+ status in neck and similarity in disease free status between treated pN+ and N0 patients there is requirement for newer techniques in diagnosis of nodes. Tumor thickness should also be considered as a factor in treatment of early tongue cancers.

Keywords: Tongue cancer, SCC of Tongue, prophylactic neck dissection, diagnosis, biopsy, lymph nodal metastasis, node status, radiotherapy, Modified neck dissection, new techniques.

References

  1. Townsend cm, editor. sabiston textbook of surgery. 20th ed.: elsevier; 2017.
  2. CJ K. Panendoscopy and simultaneous primary tumors in patients presenting with early carcinoma of the mobile tongue. british journal of oral and maxillofacial surgery. 2009 dec.
  3. Al mae. long term disease free survival in surgically resected oral tongue cancer : a 10 yr retrospective study. Acta otorhinolryngol ital. 2019 april;: 84-91.
  4. Al sje. Management of clinically negative neck in early squamous cell carcinoma of oral cavity. otolaryngolgic clinics of north america. 2005;: 37-46.
  5. Al be. exclusive low dose rate brachytherapy in 279 patients with T2N0 mobile tongue cancer. int j radiation oncology. 2005 oct;: 434-40.
  6. JA W. Survival and patterns of recurrence in 200 oral cancer patients treated by radical neck surgery and neck dissection. Oral oncology. 1999 may; 35(3): 257-265.
  7. Townsend cm, editor. sabiston textbook of surgery. 20th ed.: elsevier; 2017.
  8. CJ K. Panendoscopy and simultaneous primary tumors in patients presenting with early carcinoma of the mobile tongue. british journal of oral and maxillofacial surgery. 2009 dec.
  9. Al mae. long term disease free survival in surgically resected oral tongue cancer : a 10 yr retrospective study. Acta otorhinolryngol ital. 2019 april;: 84-91.
  10. Al sje. Management of clinically negative neck in early squamous cell carcinoma of oral cavity. otolaryngolgic clinics of north america. 2005;: 37-46.
  11. Al be. exclusive low dose rate brachytherapy in 279 patients with T2N0 mobile tongue cancer. int j radiation oncology. 2005 oct;: 434-40.
  12. JA W. Survival and patterns of recurrence in 200 oral cancer patients treated by radical neck surgery and neck dissection. Oral oncology. 1999 may; 35(3): 257-265.

Corresponding Author

K.Pujana

Post Graduate in General Surgery, NRI Medical College, Mangalagiri, India