Elective supraomohyoid neck dissection for oral cavity squamous cell carcinoma: is dissection of sublevel IIB necessary? 2008

Mohamed N Elsheikh, and Alessandra Rinaldo, and Alfio Ferlito, and Johannes J Fagan, and Carlos Suárez, and John Lowry, and Vinidh Paleri, and Avi Khafif, and Jan Olofsson
Department of Otolaryngology - Head and Neck Surgery, Tanta University, Tanta, Egypt.

Spinal accessory nerve (SAN) dysfunction and related shoulder disability are common consequences of supraomohyoid neck dissection (SOHND). Nerve dysfunction is usually attributed to excessive nerve traction or devascularization during clearance of the lymph nodes posterior and superior to the SAN (sublevel IIB). The need for routine dissection of this sublevel with elective neck dissection has recently been questioned. This review article discusses whether preserving sublevel IIB lymph nodes is justified in elective SOHND for patients with squamous cell carcinoma (SCC) of the oral cavity. A review of the literature was conducted on studies of sublevel IIB dissection in elective SOHND for SCC of the oral cavity. Only two studies have prospectively investigated the incidence of lymph node metastasis in patients with clinically N0 SCC of the oral cavity. Data from these two prospective pathologic and molecular analyses of neck dissection specimens, including 122 patients with N0 oral cancer, revealed 7.3% with positive neck nodes at sublevel IIB for oral cancer in general, and 12% for tongue cancer in particular. When considering the merits of preservation of sublevel IIB, the benefit of preservation of SAN function has to be weighed against potentially reduced oncologic control.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D009062 Mouth Neoplasms Tumors or cancer of the MOUTH. Cancer of Mouth,Mouth Cancer,Oral Cancer,Oral Neoplasms,Cancer of the Mouth,Neoplasms, Mouth,Neoplasms, Oral,Cancer, Mouth,Cancer, Oral,Cancers, Mouth,Cancers, Oral,Mouth Cancers,Mouth Neoplasm,Neoplasm, Mouth,Neoplasm, Oral,Oral Cancers,Oral Neoplasm
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D002294 Carcinoma, Squamous Cell A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed) Carcinoma, Epidermoid,Carcinoma, Planocellular,Carcinoma, Squamous,Squamous Cell Carcinoma,Carcinomas, Epidermoid,Carcinomas, Planocellular,Carcinomas, Squamous,Carcinomas, Squamous Cell,Epidermoid Carcinoma,Epidermoid Carcinomas,Planocellular Carcinoma,Planocellular Carcinomas,Squamous Carcinoma,Squamous Carcinomas,Squamous Cell Carcinomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012306 Risk The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome. Relative Risk,Relative Risks,Risk, Relative,Risks,Risks, Relative
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D061227 Accessory Nerve Injuries Traumatic injuries to the ACCESSORY NERVE. Damage to the nerve may produce weakness in head rotation and shoulder elevation. Accessory Nerve Avulsion,Accessory Nerve Contusion,Accessory Nerve Transection,Accessory Nerve Trauma,Accessory Neuropathy, Traumatic,Cranial Nerve XI Injury,Eleventh Cranial Nerve Injuries,Eleventh Cranial Nerve Injury,Eleventh-Nerve Palsy, Traumatic,Eleventh-Nerve Trauma,Injury, Cranial Nerve XI,Injury, Eleventh Cranial Nerve,Spinal Accessory Nerve Avulsion,Spinal Accessory Nerve Contusion,Spinal Accessory Nerve Injury,Spinal Accessory Nerve Transection,Spinal Accessory Nerve Trauma,Spinal Accessory Neuropathy, Traumatic,Traumatic Eleventh-Nerve Palsy,Accessory Nerve Avulsions,Accessory Nerve Contusions,Accessory Nerve Injury,Accessory Nerve Transections,Accessory Nerve Traumas,Accessory Neuropathies, Traumatic,Avulsion, Accessory Nerve,Avulsions, Accessory Nerve,Contusion, Accessory Nerve,Contusions, Accessory Nerve,Eleventh Nerve Palsy, Traumatic,Eleventh Nerve Trauma,Eleventh-Nerve Palsies, Traumatic,Eleventh-Nerve Traumas,Injuries, Accessory Nerve,Injury, Accessory Nerve,Nerve Avulsion, Accessory,Nerve Avulsions, Accessory,Nerve Contusion, Accessory,Nerve Contusions, Accessory,Nerve Injuries, Accessory,Nerve Injury, Accessory,Nerve Transection, Accessory,Nerve Transections, Accessory,Nerve Trauma, Accessory,Nerve Traumas, Accessory,Neuropathies, Traumatic Accessory,Neuropathy, Traumatic Accessory,Palsies, Traumatic Eleventh-Nerve,Palsy, Traumatic Eleventh-Nerve,Transection, Accessory Nerve,Transections, Accessory Nerve,Trauma, Accessory Nerve,Trauma, Eleventh-Nerve,Traumas, Accessory Nerve,Traumas, Eleventh-Nerve,Traumatic Accessory Neuropathies,Traumatic Accessory Neuropathy,Traumatic Eleventh Nerve Palsy,Traumatic Eleventh-Nerve Palsies
D037981 Neck Dissection Dissection in the neck to remove all disease tissues including cervical LYMPH NODES and to leave an adequate margin of normal tissue. This type of surgery is usually used in tumors or cervical metastases in the head and neck. The prototype of neck dissection is the radical neck dissection described by Crile in 1906. Radical Neck Dissection,Dissection, Neck,Dissection, Radical Neck,Dissections, Neck,Dissections, Radical Neck,Neck Dissection, Radical,Neck Dissections,Neck Dissections, Radical,Radical Neck Dissections

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