Uludag experience in the neck treatment of the tongue corpus and floor of mouth squamous cell carcinomas

Abstract

Objectives: The aim of this study is to review the treatment of the neck in tongue corpus (TC) and floor of mouth (FM) cancers which have high incidence of neck metastasis with the experience gained from our patients.Methods: Fourty-three patients who underwent primary surgery between June 1992 to April 2007 were analyzed retrospectively.Results: Forty-one neck dissections (ND) were employed in 38 patients. Neck recurrence was observed in five patients (12%). One of five (20%) clinically N0 patients who did not undergo ND had neck recurrence. On the other hand, three of 25 clinically N0 patients (12%) who had ND developed neck recurrence. Only one of 13 N(+) patients (% 8) had neck recurrence. On neck basis; among 32 patients who had selective ND, two of 19 patients with supraomohyoid ND (SOND) had neck recurrences whereas none of the 13 patients with extended SOND (ESOND) had neck recurrence. One of the neck recurrences was in the ipsilateral zone IV of a patient with SOND, another neck recurrence was in the ipsilateral zone V of a patient with modified radical ND (MRND). Remaining two patients had recurrence in the contralateral untreated neck. None of the eight clinically N1 patients who underwent selective ND had neck recurrence. Despite salvage treatments, all patients with neck recurrence died due to disease.Conclusion: The decision for excluding ND in oral cavity cancer should be given cautiously and ND should be employed in case of tumor depth more than 5 mm. We recommend ESOND as the selective ND in which zone IV is added to the dissection to be chosen in N0 patients. Selective ND's may be used effectively in selected N1 patients. Bilateral ND should be done especially in FM lesions and lesions crossing the midline.