TREATMENT OF CLINICALLY NEGATIVE NECK OF SQUAMOUS CELL CARCINOMA IN FLOOR OF MOUTH

Abstract

To determine how surgical treatment of the neck for N0 cases of squamous cell carcinoma in the floor of the mouth should be done, the pattern of occult cervical lymph node metastases was evaluated. The number of N0 cases without local failure from 1970 to 1999 was 53 (48 males and 5 females, average age 60.3 years old). T classification was as follows: T1: 14 patients, T2: 35 patients, T3: 4 patients. Initial treatment consisted of surgery only (29 patients), radiation therapy only (7 patients), surgery and radiation therapy (14 patients), surgery and chemotherapy (3 patients). Elective neck dissection (ENT) was performed in 16 patients. Histological cervical lymph node metastasis was detected in 18.9%, 2 of 16 patients who underwent ENT and 8 of 37 patients who underwent therapeutic neck dissection (TND). Frequency of secondary cervical lymph node metastasis by initial treatment and T classification distinction was not different. The sites of metastasis were level III except one case. The 5-year survival rate was 73.1% in the ENT group and 66.9% in the TND group.
The results suggest that surgical treatment of the neck is not necessary for initial treatment for N0 cases of squamous cell carcinoma in the floor of the mouth.