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The effect of conservative neck dissection in the patients with oral cancer

구강암 환자에서 보존적 경부청소술의 효과

  • Kim, Bang-Sin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Hur, Daniel (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Kim, Kyung-Rak (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Yang, Ji-Woong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Jeoung, Youn-Wook (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Kook, Min-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Oh, Hee-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University) ;
  • Park, Hong-Ju (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
  • 김방신 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 허다니엘 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김경락 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 양지웅 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 정연욱 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 국민석 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 오희균 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 유선열 (전남대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 박홍주 (전남대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2010.08.25
  • Accepted : 2010.12.15
  • Published : 2010.12.31

Abstract

Introduction: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. Materials and Methods: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). Results: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. Conclusion: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.

Keywords

References

  1. Crile G. Excision of cancer of the head and neck. With special reference to the plan of dissection based on 132 operations. JAMA 1906;47:1780-5.
  2. Martin H, Del Valle B, Ehrlich H, Cahan WG. Neck dissection. Cancer 1951;4:441-99. https://doi.org/10.1002/1097-0142(195105)4:3<441::AID-CNCR2820040303>3.0.CO;2-O
  3. Shaha AR. Radical neck dissection. Oper Tech Gen Surg 2004; 6:72-82. https://doi.org/10.1053/j.optechgensurg.2004.05.008
  4. Soo KC, Guiloff RJ, Oh A, Della Rovere GQ, Westbury G. Innervation of the trapezius muscle: a study in patients undergoing neck dissections. Head Neck 1990;12:488-95. https://doi.org/10.1002/hed.2880120607
  5. Dulguerov P, Soulier C, Maurice J, Faidutti B, Allal AS, Lehmann W. Bilateral radical neck dissection with unilateral internal jugular vein reconstruction. Laryngoscope 1998;108:1692-6. https://doi.org/10.1097/00005537-199811000-00019
  6. Suarez O. El problema de las metastasis linfa′ticas y alejadas del cancer de laringe e hipofaringe. Rev Otorrinolaringol 1963;23: 83-99.
  7. Bocca E. Conservative neck dissection. Laryngoscope 1975;85: 1511-15. https://doi.org/10.1288/00005537-197509000-00013
  8. Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology. Official report of the Academy's Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg 1991;117:601-5. https://doi.org/10.1001/archotol.1991.01870180037007
  9. O'Brien CJ, Urist MM, Maddox WA. Modified radical neck dissection. Terminology, technique, and indicaction. Am J Surg 1987;153:310-6. https://doi.org/10.1016/0002-9610(87)90614-3
  10. Medina JE, Byers RM. Supraomohyoid neck dissection: rationale, indications, and surgical technique. Head Neck 1989;11: 111-22. https://doi.org/10.1002/hed.2880110203
  11. Medina JE. A rational classification of neck dissections, Otolaryngol Head Neck Surg 1989;100:169-76. https://doi.org/10.1177/019459988910000301
  12. Shah JP. Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg 1990;160:405-9. https://doi.org/10.1016/S0002-9610(05)80554-9
  13. Byers RM. Modified neck dissection. A study of 967 cases from 1970 to 1980. Am J Surg 1985;150:414-21. https://doi.org/10.1016/0002-9610(85)90146-1
  14. Byers RM, Wolf PF, Ballantyne AJ. Rationale for elective modified neck dissection. Head Neck Surg 1988;10:160-7. https://doi.org/10.1002/hed.2890100304
  15. Yousem DM, Som PM, Hackney DB, Schwaibold F, Hendrix RA. Central nodal necrosis and extracapsular neoplastic spread in cervical lymph nodes: MR imaging versus CT. Radiology 1992;182:753-9. https://doi.org/10.1148/radiology.182.3.1535890
  16. Hao SP, Ng SH. Magnetic resonance imaging versus clinical palpation in evaluating cervical metastasis from head and neck cancer. Otolaryngol Head Neck Surg 2000;123:324-7. https://doi.org/10.1067/mhn.2000.105252
  17. Houck JR, Medina JE. Management of cervical lymph nodes in squamous carcinomas of the head and neck. Semin Surg Oncol 1995;11:228-39. https://doi.org/10.1002/ssu.2980110308
  18. Ali S, Tiwari RM, Snow GB. False-positive and false negative neck nodes. Head Neck Surg 1985;8:78-82. https://doi.org/10.1002/hed.2890080204
  19. Desanto LW, Beahrs OH. Modified and complete neck dissection in the treatment of squamous cell carcinoma of the head and neck. Surg Gynecol Obstet 1988;167:259-69.
  20. Friedman M, Mafee MF, Pacella BL Jr, Strorigl TL, Dew LL, Toriumi DM. Rationale for elective neck dissection in 1990. Laryngoscope 1990;100:54-9.
  21. Yu MG, Ryu SY. Usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. J Korean Assoc Oral Maxillofac Surg 2009;35:213-20.
  22. Belhocine T, Spaepen K, Dusart M, Castaigne C, Muylle K, Bourgeois P, et al. $^{18}FDG$ PET in oncology: the best and the wost (Review). Int J Oncol 2006;28:1249-61.
  23. Bray F, Sankila R, Ferlay J, Parkin DM. Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer 2002;38:99-166. https://doi.org/10.1016/S0959-8049(01)00350-1
  24. Llewellyn CD, Johnson NW, Warnakulasuriya KA. Risk factors for squamous cell carcinoma of the oral cavity in young people-a comprehensive literature review. Oral Oncol 2001;37:401-18. https://doi.org/10.1016/S1368-8375(00)00135-4
  25. Hindle I, Downer MC, Speight PM. The epidermiology of oral cancer. Br J Oral Maxillofac Surg 1996;34:471-6. https://doi.org/10.1016/S0266-4356(96)90111-4
  26. Arbes SJ Jr, Olshan AF, Caplan DJ, Schoenbach VJ, Slade GD, Symons MJ. Factors contributing to the poorer survival of black Americans diagnosed with oral cancer (United states). Cancer Causes Control 1999;10:513-23. https://doi.org/10.1023/A:1008911300100
  27. Shiboski CH, Shiboski SC, Silverman S Jr. Trends in oral cancer rates in the United States, 1973-1996. Community Dent Oral Epidemiol 2000;28:249-56. https://doi.org/10.1034/j.1600-0528.2000.280402.x
  28. Chandu A, Adams G, Smith AC. Factors affecting survival in patients with oral cancer: an Australian perspective. Int J Oral Maxillofac Surg 2005;34:514-20. https://doi.org/10.1016/j.ijom.2004.10.006
  29. Lung T, Tascau OC, Almasan HA, Mure¸san O. Head and neck cancer, epidemiology and histological aspects-Part 1: a decade's results 1993-2002. J Craniomaxillofac Surg 2007;35:120-5. https://doi.org/10.1016/j.jcms.2007.02.001
  30. Cho JH, Kim CS. Clinical and statistical analysis of the oral cancer patients: a statistical analysis of 256 cases. J Korean Assoc Maxillofac Plast Reconstr Surg 1998;20:33-44.
  31. Funk GF, Karnell LH, Robinson RA, Zhen WK, Tras DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head Neck 2002;24: 165-80. https://doi.org/10.1002/hed.10004
  32. Hindle I, Nally F. Oral Cancer: a comparative study between 1962-67 and 1980-84 in England and Wales. Br Dent J 1991;170:15-20. https://doi.org/10.1038/sj.bdj.4807395
  33. Budhy TI, Soenarto SD, Yaacob HB, Ngeow WC. Changing incidence of oral and maxillofacial tumours in East Java, Indonesia, 1987-1992. Part 2: malignant tumours. Br J Oral and Maxillofac Surg 2001;39:460-4. https://doi.org/10.1054/bjom.2001.0718
  34. Rawashdeh MA, Matalka I. Malignant oral tumors in Jordanians, 1991-2001. A descriptive epidemiological study. Int J Oral Maxillofac Surg 2004;33:183-8. https://doi.org/10.1054/ijom.2003.0494
  35. Khafif RA, Gelbfish GA, Asase DK, Tepper P, Attie JN. Modified radical neck dissection in cancer of the mouth, pharynx, and larynx. Head Neck 1990;12:476-82. https://doi.org/10.1002/hed.2880120605
  36. Chu W, Strawitz JG. Results in suprahyoid, modified radical, and standard radical neck dissections for metastatic squamous cell carcinoma: recurrence and survival. Am J Surg 1978;136:512-5. https://doi.org/10.1016/0002-9610(78)90272-6
  37. Hao SP, Tsang NM. The role of supraomohyoid neck dissection in patients of oral cavity carcinoma (small star, filled). Oral Oncol 2002;38:309-12. https://doi.org/10.1016/S1368-8375(01)00061-6
  38. Chan SW, Mukesh BN, Sizeland A. Treatment outcome of N3 nodal head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg 2003;129:55-60. https://doi.org/10.1016/S0194-5998(03)00477-7