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• W2023702120 abstract "The cervical lymph node status is one of the most important prognostic factors in oral tongue SCC. To assess the nodal status, CT, MRI, ultrasonography, and PET have been used, and currently good quality of CT is the imaging study of choice for nodal stage. However, even these imaging modalities hardly detect micrometastases. When a “wait and see” policy is used for the neck at risk for metastases, patients tend to fail with advanced nodal disease, even with close follow-up. So in light of the tumor characteristics influencing the propensity for nodal metastases, it has been suggested that if the probability of metastases to cervical lymph nodes exceeds 20%, then neck dissection is warranted. However, the probability of metastases is hardly determined. In general, for clinically N- patients with T1 or early T2 tumor, “wait and see” is adopted. For clinically N- patients with late T2 or more disease, supraomohyoid neck dissection (SOHND) is recommended, and extended SOHND clearing nodal level IV in addition to levels I, II and III is indicated in selected patients. Sentinel lymph node biopsy is under investigation in clinically N- patients. In clinically N+ patients, neck dissection is the most widely accepted treatment. Various types of neck dissection are performed depending on the nodal stage and minimizing the morbidity of the procedure. In this setting, radical neck dissection (RND) or modified RND sparing the SAN, IJV or SCM is indicated. SOHND in clinically N+ patients is controversial, however, it is often advocated in N1 patients whose metastasis involves the level I node without evidence of extracapsular spread (ECS) of tumor. Lingual lymph nodes, small, interrupting nodules located deeply above the suprahyoid region along the course of the lymphatic vessels draining the tongue are infrequently involved, so they should be included in dissection in selected patients. Risk factors for failure in the neck or distant sites are the presence of ECS of tumor, and presence of multiple nodes involved at multiple levels of the neck. In patients with such advanced neck disease, postoperative chemoradiotherapy may decrease the rate of failure." @default.
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• W2023702120 date "2007-09-01" @default.
• W2023702120 modified "2023-09-25" @default.
• W2023702120 title "Mandatory Indication for Neck Dissection Based on Long-Term Results" @default.
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• W2023702120 doi "https://doi.org/10.1016/j.joms.2007.06.071" @default.
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