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Prospective study of 583 neck dissections in oral cancers: Implications for clinical practice
Author(s) -
Pantvaidya Gouri H.,
Pal Pooja,
Vaidya Abhishek D.,
Pai Prathamesh S.,
D'Cruz Anil K.
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23494
Subject(s) - medicine , neck dissection , prospective cohort study , incidence (geometry) , lymph node , dissection (medical) , metastasis , cancer , lymph node metastasis , logistic regression , histopathology , radiology , oncology , surgery , pathology , physics , optics
Background Determining the level of nodal metastases may help decrease the extent of neck dissections and reduce morbidity. Methods A prospective study of neck dissections in patients with oral cancer was conducted. Each nodal level was delineated, sent for histopathology, and reported level‐wise. Incidence of overall and isolated metastatic nodes at different levels was calculated. Logistic regression was used to find factors predicting metastases to levels IIB and V. Results Five hundred eighty‐three neck dissections were prospectively evaluated. A total of 95.7% metastases occurred at levels I to IV. Overall incidence of metastases to levels IIB and V was 3.8% and 3.3%, respectively. Multivariate analysis revealed IIA positivity as an independent predictive factor for metastases to both IIB and V. Conclusion This study of lymph node mapping in patients with oral cancer showed a predictable pattern of lymph node metastasis according to primary site. Selective neck dissection (levels I–IV) in patients with oral cancers may be adequate. Determining status of level IIA is important to guide dissection of levels IIB and V. © 2014 Wiley Periodicals, Inc. Head Neck , 36: 1503–1507, 2014