Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts
ABSTRACT The records of 2,044 patients with previously untreated squamous cell carcinomas of the head and neck were reviewed in order to define the incidence and topographical distribution of lymph node metastasis on admission. The common regions of metastasis are presented for each of the seven individual head and neck sites selected for study. Knowledge of the preferred areas of spread and those that are almost never involved allows the design of more adequate plans to manage the individual lesions.
- SourceAvailable from: Juan P Rodrigo[show abstract] [hide abstract]
ABSTRACT: It has been established that an appropriately indicated selective neck dissection can achieve the same oncologic results as more extensive dissections. An even more modified selective neck dissection, termed superselective neck dissection, involves the compartmental removal of the fibrofatty tissue contents within the defined boundaries of two or fewer contiguous neck levels. Evidence from retrospective studies suggests that superselective neck dissection (SSND) is oncologically sound for two indications: elective treatment of the clinically N0 neck and salvage treatment of persistent lymph node disease after chemoradiotherapy. While there is broader support for the former scenario, evidence that SSND may constitute optimal treatment in the latter is in conformity with the trend toward developing surgical techniques that provide better functional outcomes without compromising efficacy.Archives of Oto-Rhino-Laryngology 01/2013; · 1.29 Impact Factor
- Archives of Oto-Rhino-Laryngology 10/2012; · 1.29 Impact Factor
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ABSTRACT: Optimal elective neck treatment in node-negative (cN0) oropharyngeal squamous cell carcinoma (OPSCC) patients is still controversially discussed. Retrospective chart review of 49 cT1-3 cN0 cM0 OPSCC patients, who had undergone surgical resection of the primary and either elective neck dissection (END) (n = 32) or observation (OBS) (n = 17) of the neck was performed. For systematic review of literature, Pubmed and EMBASE were searched for clinical studies including data on both END and OBS of the neck in cN0 OPSCC patients. Estimated 5-year overall survival (OS) rate was 82 % for END and 76 % for OBS [hazard ratio (HR) = 1.01]. Estimated 5-year disease-free survival (DFS) rate was 78 % for END and 67 % for OBS (HR = 1.79); 5-year DSS rate was 97 % (END) and 81 % (OBS) (HR = 2.22). None of the primary outcome variables (OS, DFS, DSS) revealed statistically significant effects for the treatment assignments. Hazard ratios implied an advantage for END. Systematic review of literature yielded only retrospective chart reviews and no data meeting our selection criteria for further data analysis. Due to lack of high-level evidence, the decision for END in cN0 OPSCC remains a diagnostic and therapeutic challenge. The demonstrated clinical equipoise would provide a solid basis for a multicentric, randomized trial.Archives of Oto-Rhino-Laryngology 05/2013; · 1.29 Impact Factor