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Ipsilateral neck cancer recurrences after elective supraomohyoid neck dissection
A L Carvalho1, L P Kowalski, J A Borges
1Department of Head and Neck Surgery and Otolaryngology, Centro de Tratamento e Pesquisa, Hospital do Câncer A. C. Camargo, São Paulo, Brazil.
Design:
Retrospective analysis of a case series.
Setting:
Referral center, private or institutional practice, hospitalized care.
Objective:
To analyze the level (site) of ipsilateral neck recurrences after supraomohyoid (SOH) dissection in patients with lip, oral, and oropharyngeal cancer treated in a single institution.
Intervention:
Supraomohyoid neck dissection.
Patients And Methods:
From 1979 to 1997, 154 patients with oral and oropharyngeal carcinoma and no palpable lymph nodes at the neck underwent ipsilateral elective SOH dissection.
Results:
Tumor sites were the lip, 5 cases (3.3%); oral cavity, 128 cases (83.1%); and oropharynx, 21 cases (13.6%). Tumor stages were T1, 13 cases (8.4%); T2, 77 cases (50.0%); T3, 40 cases (27.0%); and T4, 22 cases (14.3%). There were 7 cases (4.5%) of ipsilateral neck recurrences. Three were beyond the limits of the SOH dissection, and 4 were inside these limits. There was no association of neck recurrences with the pathological status of the lymph nodes. Six of the 7 recurrences were in patients who underwent postoperative radiotherapy.
Conclusions:
The incidence of neck recurrence after selective neck dissection was 4.5%, and it occurred either inside (57.1%) or beyond (42.9%) the limits of the selective neck dissection.