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第36巻 第2号 >

Management of the N0 Neck in Early Stage Oral Squamous Cell Carcinoma

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/60954

Title: Management of the N0 Neck in Early Stage Oral Squamous Cell Carcinoma
Authors: Mitsunobu, Ono Browse this author →KAKEN DB
Kazuyo, Kuribayashi Browse this author
Yuichi, Ashikaga Browse this author →KAKEN DB
Yoichi, Ohiro Browse this author →KAKEN DB
Kanchu, Tei Browse this author →KAKEN DB
Keywords: Oral squamous cell carcinoma
Occult lymph node metastasis
Elective neck dissection
“ Wait and see” policy
Issue Date: Mar-2016
Publisher: 北海道歯学会
Journal Title: 北海道歯学雑誌
Volume: 36
Issue: 2
Start Page: 128
End Page: 133
Abstract: Management of clinically node negative neck patients with oral squamous cell carcinoma (OSCC) remains controversial. Elective neck dissection (END) is used on an assumption of difficulty in diagnosing subclinical nodal metastases in the neck. This is also the case when early dissection allows better prognosis if nodal metastases actually exist. However, the disadvantage of prophylactic END is that truly N0 neck patients undergo unnecessary neck dissection and have to bear shoulder complaints and dysfunction. Our strategy has been a“ wait and see” policy for the management of the neck among patients with T1-2 oral cancer without clinical nodal metastases unless the neck was being opened for reconstruction requirements. The purpose of this study is to assess the outcome of patients who underwent trans-oral tumor excision and“ wait-and-see” policy for the N0 neck.  A total of 94 previously untreated patients with T1-2N0 classification were investigated. Elective neck dissection (END) was carried out on 10 patients (10.6%) at the time of treatment of the primary resection with reconstruction (END group), and 84 patients were observed without neck dissection (Observation group).  The 5-year disease specific survival rates were 90.0% for the END group and 95.9% for the observation group. The 5-year over all survival rates were 90.0% in the END group and 88.8% in the observation group. In the observation group of 84 patients, 16 patients (19.0%) had delayed metastasis in the neck subsequently. 15 patients underwent salvage neck dissection. The salvage rate was 86.6% (13/15 patients).  The treatment strategy “wait and see” policy for T1-2N0 OSCC resulted in a good outcome at our institution. Unnecessary neck dissection can be avoided for the truly N0 patients.
Type: article
URI: http://hdl.handle.net/2115/60954
Appears in Collections:北海道歯学雑誌 = Hokkaido Journal of Dental Science > 第36巻 第2号

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