• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.3
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• pp.147-151
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• 2017

Objectives: The purpose of this study was to evaluate and compare the treatment outcomes of partial glossectomy with or without elective neck dissection in patients with tongue squamous cell carcinoma (SCCa). Materials and Methods: A total of 98 patients who were diagnosed with tongue SCCa and underwent partial glossectomy between 2005 and 2014 were evaluated. Only 14 patients received elective neck dissection, and 84 patients received only partial glossectomy. Results: There were 56 men and 42 women with a mean age of 57 years and mean follow-up period of 33.7 months. There were 70 patients graded as T1 and 28 as T2. The total occult metastasis rate was 17.3%. The 5-year overall survival rate was 83.3% with elective neck dissection and 92.4% with observation. The 5-year disease-free survival rate was in 70.7% in the elective neck dissection group and 65.3% in the observation group. Conclusion: We retrospectively reviewed the records of 98 patients with tongue SCCa. These patients were divided into two groups, those who underwent elective neck dissection and those who did not. There was no statistically significant difference between the groups undergoing partial glossectomy with or without elective neck dissection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.6
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• pp.591-596
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• 2007

Neck node metastasis of oral cancer can be diagnosed by bimanual palpation, CT, MRI and neck sonography and the final diagnosis can be confirmed by pathologic evaluation of the neck nodes after elective neck dissection. When we meet clinically negative neck node(N0 neck) of oral squamous cell carcinoma, the treatment modality of the neck nodes with the primary lesions are so controversial. The usually used methods are various from close observation to elective radiation and elective neck dissection. The methods can be chosen by the primary size of the carcinoma, site of the lesions and the expected percentage of the occult metastasis to the neck. We reviewed the 86 patients from 1996 to 2006 who were diagnosed as oral squamous cell carcinoma, whose necks were diagnosed negative in radiographically and clinically. According to TNM stage, the patients were in the states of N0 and treated by surgery using mass excision and elective neck dissection. We compared the differences between the clinical diagnoses and pathologic reports and would discuss the needs for elective neck dissection.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.19-23
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• 2004

Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

• Korean Journal of Head & Neck Oncology
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• v.7 no.1
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• pp.10-16
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• 1991

Elective neck dissection (END), provide proper information on nodal status and stage which are significant prognosticator in head and neck cancers with clinically $N_{(0)}$ neck. But there are many controversies for the extents, methods of surgery, moreover, whether normal lymph nodes, local defencer, have to be removed or not. The authors performed 47 END in 39 patients of head and neck squamous cell carcinoma from 1984 to 1989 and a retrospective study of the cases was conducted. Eighteen percent of nodal metastasis and five percent of extracapsular spread were found in END specimens. We concluded that END provide significant information for the management and evaluation of prognosis in head and neck cancer.

• The Journal of the Korean dental association
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• v.48 no.8
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• pp.594-606
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• 2010

Lymph node status is the single most important prognostic factor in oral cancer because lymph node involvement decreases overall survival by 50%. Appropriate management of the regional lymphatics, therefore, plays a central role in the treatment of the oral cancer patients. The purposes of this article are to present the history of neck dissections, including current neck dissection classification, describe the technique of the most common neck dissection applicable to oral cavity cancers, and discuss some of the complications associated with neck dissection. Finally, a brief review of elective neck dissection and sentinel lymph node biopsy will be presented. It is necessary that dentists have to be interested in oral cancer and these interest will make it possible to prevent oral cancer, detect it earlier and also improve the prognosis, survival and the quality of life of survivors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.6
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• pp.358-364
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• 2016

Objectives: To evaluate the results of elective neck dissection versus those of observation in the treatment of early stage oral squamous cell carcinoma and to identify factors related to recurrence and survival. Materials and Methods: This was a retrospective study of 52 patients who underwent elective neck dissection and 27 who did not receive neck dissection. Results: In survival analyses, elective neck dissection showed a benefit in overall recurrence (P=0.027), especially in stage I patients (P=0.024). With regard to survival, the benefit was statistically insignificant (P=0.990). In multivariable analysis, overall recurrence was independently related to poor histologic grade (odds ratio [OR]=9.65, P=0.006), and cancer-specific death was independently related to advanced age (OR=6.3, P=0.022), higher clinical T stage (OR=15.2, P=0.01), and poorly differentiated histologic grade (OR=6.6, P=0.025). Conclusion: Though there was lower recurrence in the elective neck dissection group, there were no statistically significant results on survival. The characteristics of the tumor itself, such as clinical T stage and poor histologic grade, may be more important in cancer-specific survival.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.24-29
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• 1997

Background: Supraglottic and hypopharyngeal regions drain into the upper deep cervical lymph nodes. And bilateral neck node metastasis is frequently occured especially, in the early stage. It influences on the prognosis of above diseases. The prognosis for patients wih supraglottic and hypopharyngeal cancers, although usually poor, has improved by modern imaging technique, better application of treatment modalities, increasing assortment of reconstructive procedures and improved application of radiation therapy. Objectives: This study was designed to obtain objective data about the patterns of neck node metastasis and to identify the necessity of elective bilateral neck dissection. Material and Methods: Twenty four patients with supraglottic cancer and twenty six patients with hypopharyngeal cancer were investigated from the chart review. Results: In supraglottic cancer, the most frequent sites of neck metastasis is level II (52.9%) and level III (52.9%) in ipsilateral side, level II (29.4%) in contralateral side, in hypopharyngeal cancer, level II (73.7%) and III (52.6%) in ipsilateral side, level II (10.5%) in contralateral side. In elective neck dissection, the occult metastasis is about 50% in supraglottic cancer, but there is no occult metastasis in hypopharyngeal cancer. Conclusion: In supraglottic cancer, elective bilateral neck dissection is necessary because of early contralateral neck metastasis, but in hypopharyngeal cancer, elective contralateral neck dissection may not be always necessary because of rare occult metastasis and contralateral neck metastasis.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.194-197
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• 2001

Background and Objectives: Supraglottic cancer have a great tendency to spread cervical lymph nodes and lymph node metastasis is a well known prognostic factor. However the treatment for N0 neck in supraglottic cancer is still controversial. Materials and Methods: We retrospectively analyzed our neck management of supraglottic cancer patients who present with cN0 contralateral neck from 1989 through 1997. 36 patients were eligible for analysis. The primary site was surgically removed and the neck was managed by elective neck irradiation (ENI), elective neck dissection (END), or therapeutic neck dissection (TND) with postoperative radiation therapy (PORT). Results: Our results revealed that 18 of 36 patients have clinically negative neck, another 18 patients have clinically positive neck (N1-3). In clinically negative group, 12 of 18 patients were received ENI and there was 1 failure in contralateral neck area. Remaining 6 patients were received END with PORT and there was no failure. In clinically positive neck group, 3 of 18 patients were received ipsilateral TND and an additional contralateral END with PORT. Remaining 15 patients who were received TND with PORT, developed 3 neck failure. Conclusion: ENI or ipsilateral or bilateral END can be done in the cN0 neck of supraglottic cancer however ipsilateral TND and contralateral END with PORT is reasonable for the cN(+) neck.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.3
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• pp.166-170
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• 2017

Objectives: To define the risk of occult cervical metastasis of maxillary squamous cell carcinoma (SCC) and the therapeutic value of elective neck dissection (END) in survival of clinically negative neck node (cN0) patients. Materials and Methods: Sixty-seven patients with maxillary SCC and cN0 neck were analyzed retrospectively, including 35 patients with maxillary gingiva and 32 patients with maxillary sinus. Results: Of 67 patients, 10 patients (14.9%) had occult cervical metastasis. The incidence of occult cervical metastasis of maxillary gingival SCC was higher than that of maxillary sinus SCC (17.1% and 12.5%, respectively). The 5-year overall survival rate was 51.9% for the END group and 74.0% for the non-END group. The success rate of treatment for regional recurrence was high at 71.4%, whereas that for local or locoregional recurrence was low (33.3% and 0%, respectively). Conclusion: The incidence of occult cervical metastasis of maxillary SCC was not high enough to recommend END. For survival of cN0 patients, local control of the primary tumor is more important than modality of neck management. Observation of cN0 neck is recommended when early detection of regional recurrence is possible irrespective of the site or T stage. The key enabler of early detection is patient education with periodic follow-up.