Abstract
We analyzed the feasibility of performing selective neck dissection in oral cavity squamous cell carcinoma (SCC) patients according to clinical neck stage and primary subsite.
We reviewed the records of 394 patients who underwent neck dissection between April 2001 and December 2011 in our department.
In the cN0 group, occult cervical lymph node metastasis was histologically confirmed in 51 patients. Distribution of cervical lymph node metastasis was level Ia in 2 patients, Ib in 19, IIa in 28, III in 4, and others in 3. The primary tumor sites of the cases with level III metastasis were tongue in 3 patients and lower gum in 1 patient. For elective neck dissection, dissection of levels I + IIa + III is recommended in patients with SCC of the tongue and lower gum, while dissection of levels I + IIa is applicable in patients with SCC of other subsites.
In the cN1 group, the distribution of lymph node metastasis was level IV in one patient, others in 2, as well as levels I-III. The primary site of the case that involved level IV nodes was the tongue. Patients with tongue SCC should have level I-IV nodes removed. In addition, the dissection of levels I-III is an appropriate treatment for patients with other SCC.
In the cN2b group, the metastatic nodes were located in levels I-V. It is necessary to dissect level I-V nodes in patients with cN2b disease.
