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Supraomohyoid neck dissection. Is it diagnostic or therapeutic?
J D Kerrebijn1, J L Freeman, J C Irish
1Department of Otolaryngology/Head and Neck Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Head & Neck
|January 16, 1999
Summary
Supraomohyoid neck dissection (SOHND) effectively stages oral cancer patients. While it controls most neck disease, recurrence and survival are not linked to pathology N stage, suggesting further study is needed.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Cancer
Background:
- Supraomohyoid neck dissection (SOHND) is a common procedure for oral cavity cancer with no regional metastases.
- Its role as a curative operation versus a staging procedure is debated when positive nodes are found pathologically.
Purpose of the Study:
- To evaluate the efficacy of SOHND as a staging procedure in oral cavity cancer.
- To determine the relationship between pathological N stage and neck recurrence/patient survival after SOHND.
Main Methods:
- Retrospective review of 43 oral cavity cancer patients who underwent 48 SOHNDs between 1991-1994.
- All patients were initially staged as N0, with a minimum follow-up of 2 years.
Main Results:
- Occult metastasis was found in 15% (7/48) of N0-staged necks.
- Neck recurrence occurred in 14% of pathologically node-positive cases and 10% of pathologically node-negative cases.
- Patient survival rates were similar for both pathologically N0 (88%) and N+ (86%) groups.
Conclusions:
- SOHND serves as an effective staging procedure for oral cavity cancer.
- Neck recurrence and survival post-SOHND do not appear to be significantly related to pathological N stage.
- SOHND, with or without adjuvant radiotherapy, generally controls neck disease, but a prospective study comparing it to a "wait and see" approach is warranted.