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Surgical Management of Cervical Lymph Nodes in Patients with Oral and Oropharyngeal Cancer

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Carcinoma of the Oral Cavity and Oropharynx

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 134))

Abstract

The incidence of neck metastases in oral cancer is approximately 50%, whereas cancers arising in the oropharynx have a metastatic rate of well over 50%. In general, it holds true that the more advanced the primary tumour, the higher the incidence of cervical metastases. The distribution of lymphatic metastases is, for the most part, explicable in mechanical and anatomical terms (Lindberg 1972; Shah 1990; Shah et al. 1990; Candela et al. 1990). The filter and barrier function of lymph nodes appears to be effective in the initial stage, as lymphatic spread is generally limited initially to the first echelon of lymph nodes.

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References

  • Ali S, Tiwari RM, Snow GB (1985) False positive and false negative neck nodes. Head Neck Surg 8: 78–82

    Article  PubMed  CAS  Google Scholar 

  • Baatenburg de Jong RJ, Rongen RJ, Jong PC de, Lameris JS, Knegt P (1988) Screening for lymph nodes in the neck with ultrasound. Clin Otolaryngol 13: 5–9

    Article  Google Scholar 

  • Baatenburg de Jong RJ, Rongen RJ, Lameris JS, Harthoorn M, Verwoerd CDA, Knegt P (1989) Metastatic neck disease: palpation vs ultrasound examination. Arch Otolaryngol Head Neck Surg 115: 689–690

    Article  PubMed  CAS  Google Scholar 

  • Bartelink H, Breur K, Hart G, Annyas AA, Slooten EA van, Snow GB (1983) The value of postoperative radiotherapy as an adjuvant to radical neck dissection. Cancer 52: 1008–1013

    Article  PubMed  CAS  Google Scholar 

  • Bocca E, Pignataro O (1967) A conservative technique in radical neck dissection. Ann Otol Rhinol Laryngol 76: 975–988

    PubMed  CAS  Google Scholar 

  • Bocca E, Pignataro O, Oldini C, Cappa C (1984) Functional neck dissection: an evaluation and reviews of 843 cases. Laryngoscope 94: 942–945

    PubMed  CAS  Google Scholar 

  • Bruneton JN, Normand F (1987) Cervical lymph nodes. In: Bruneton JN (ed) Ultrasonography of the neck. Springer, Berlin Heidelberg New York, pp 81–91

    Chapter  Google Scholar 

  • Bruneton JN, Roux P, Caramella E, Demard F, Vallicioni J, Chauvel P (1984) Ear, nose and throat cancer: ultrasound diagnosis of metastases to cervical lymph nodes. Radiology 152: 771–773

    PubMed  CAS  Google Scholar 

  • Cachin Y, Sancho-Garnier H, Micheau C, Marandas P (1979) Nodal metastases from carcinomas of the oropharynx. Otolaryngol Clin North Am 12: 145–154

    PubMed  CAS  Google Scholar 

  • Candela FC, Kotharai K, Shah JP (1990) Patterns of cervical lymph node metastases from squamous carcinoma of the oropharynx and hypopharynx. Head Neck 10: 160–167

    Google Scholar 

  • Carenfelt C, Eliasson K (1981) Radical neck dissection and permanent sequelae associated with spinal accessory nerve injuries. Acta Otolaryngol (Stockh) 91: 155–160

    Article  Google Scholar 

  • Chow JM, Levin BC, Krivit JS, Applebaum EA (1989) Radiotherapy or surgery for subclinical cervical node metastases. Arch Otolaryngol Head Neck Surg 115: 981–984

    Article  PubMed  CAS  Google Scholar 

  • Close LG, Burns DK, Reisch J, Schaefer SD (1987) Microvascular invasion in cancer of the oral cavity and oropharynx. Arch Otolaryngol Head Neck Surg 113: 1191–1195

    Article  PubMed  CAS  Google Scholar 

  • Crile G (1906) Excision of cancer of the head and neck with special reference to the plan of dissection based on 132 operations. JAMA 47: 1780–1786

    Article  Google Scholar 

  • Dayal VS, da Silva A J (1971) Functional and radical neck dissection. Arch Otolaryngol 93: 413–415

    Article  PubMed  CAS  Google Scholar 

  • Feinmesser R, Freeman JL, Noyek AM, Birt D (1987) Metastatic neck disease. A clinical/radiographic/pathologic correlative study. Arch Otolaryngol Head Neck Surg 113: 1307–1310

    Google Scholar 

  • Feinmesser R, Freeman JL, Noyek AM, Birt D, Gullane P, Mullen JB (1990) MRI and neck metastases: a clinical, radiological, pathological correlative study. J Otolaryngol 19: 136–140

    PubMed  CAS  Google Scholar 

  • Friedman M, Shelton VK, Mafee M, Bellity P, Grybauskas V, Skolnik E (1984) Metastatic neck disease: evaluation by computed tomography. Arch Otolaryngol 110: 443–447

    Article  PubMed  CAS  Google Scholar 

  • Friedman M, Mafee MF, Pacella BL, Strorigl TL, Dew LL, Toriumi DM (1990a) Rationale for elective neck dissection in 1990. Laryngoscope 100: 54–59

    PubMed  CAS  Google Scholar 

  • Friedman M, Toriumi DM, Mafee MF, Strorigl T (1990b) The role of computed tomographic scanning in evaluating the clinically negative neck. In: Fee WE, Goepfert H, Johns ME, Strong EW, Ward PH (eds) Head and neck cancer, vol 2. Decker, Toronto, pp 138–144

    Google Scholar 

  • Hajec PC, Solomonowitz E, Turk R, Tscholakoff D, Kumpan W, Czembirek H (1986) Lymph nodes of the neck: evaluation with ultrasound. Radiology 158: 739–742

    Google Scholar 

  • Hermanek P, Sobin LH (eds) (1987) TNM classification of malignant tumours. Springer, Berlin Heidelberg New York, p 14

    Chapter  Google Scholar 

  • Hibbert J, Marks NJ, Winter PJ, Shaheen OH (1983) Prognostic factors in oral squamous cell carcinoma and their relation to clinical staging. Clin Otolaryngol 8: 197–203

    Article  PubMed  CAS  Google Scholar 

  • Lee JG, Krause CJ (1975) Radical neck dissection. Elective, therapeutic and secondary. Arch Otolaryngol 101: 656–659

    Google Scholar 

  • Leemans CR, Tiwari R, Waal I van der, Karim ABMF, Nauta JJP, Snow GB (1990) The efficacy of comprehensive neck dissection with or without postoperative radiotherapy in nodal metastases of squamous cell carcinoma of the upper respiratory and digestive tracts. Laryngoscope 100: 1194–1198

    Article  PubMed  CAS  Google Scholar 

  • Leemans CR, Tiwari R, Nauta JJP, Waal I van der, Snow GB (1992) Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer (in press)

    Google Scholar 

  • Lindberg RD (1972) Distribution of cervical lymph node metastases for squamous cell carcinoma of the upper respiratory tract. Cancer 29: 1446–1449

    Article  PubMed  CAS  Google Scholar 

  • Lingeman RE, Helmus C, Stephens R, Ulm J (1977) Neck dissection: radical or conservative. Ann Otol Rhinol Laryngol 86: 737–744

    PubMed  CAS  Google Scholar 

  • Mancuso AA, Maceri D, Rice D, Hanafee W (1981) CT of cervical lymph node cancer. A J R 136: 381–385

    CAS  Google Scholar 

  • Mancuso AA, Harnsberger HR, Muraki AS, Stevens MH (1983) Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer: II. Pathology. Radiology 198: 715–723

    Google Scholar 

  • Mantravadi RVP, Skolnik EM, Haas RE, Applebaum EL (1983) Patterns of cancer recurrence in the postoperatively irradiated neck. Arch Otolaryngol 109: 753–756

    Article  PubMed  CAS  Google Scholar 

  • Medina JE, Byers RM (1989) Supraomohyoid neck dissection: rationale, indications, and surgical technique. Head Neck Surg 11: 111–122

    Article  CAS  Google Scholar 

  • Mendenhall WM, Million RR, Cassisi NJ (1980) Elective neck irradiation in squamous cell carcinoma of the head and neck. Head Neck Surg 3: 15–20

    Article  PubMed  CAS  Google Scholar 

  • Merino OR, Lindberg RD, Fletcher GH (1977) An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 40: 145–151

    Article  PubMed  CAS  Google Scholar 

  • Molinari R, Cantu G, Chiesa F, Grandi C (1980) Retrospective comparison of conservative and radical neck dissection in laryngeal cancer. Ann Otol Rhinol Laryngol 89: 578–581

    PubMed  CAS  Google Scholar 

  • Ogura JH, Biller HF, Wette R (1971) Elective neck dissection for pharyngeal and laryngeal cancers: an evaluation. Ann Otol Rhinol Laryngol 80: 646–651

    PubMed  CAS  Google Scholar 

  • Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW (1991) Standardizing neck dissection terminology - official report of the Academy’s Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg 117: 601–605

    Article  PubMed  CAS  Google Scholar 

  • Sako K, Pradier RN, Marchetta FC, Pickren JW (1964) Fallibility of palpation in the diagnosis of metastases to the cervical nodes. Surg Gynecol Obstet 118: 989–990

    PubMed  CAS  Google Scholar 

  • Schuller DE, Reiches NA, Hamaker RC, Lingeman RE, Weisberger EC, Suen JY, Conley JJ, Kelly DR, Miglets AW (1983) Analysis of disability resulting from treatment including radical neck dissection or modified neck dissection. Head Neck Surg 6: 551–558

    Article  PubMed  CAS  Google Scholar 

  • Shah JP (1990) Patterns of cervical lymph node metastases from squamous carcinoma of the upper aerodigestive tract. Am J Surg 160: 405–409

    Article  PubMed  CAS  Google Scholar 

  • Shah JP, Candela FC, Poddar AK (1990) The patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity. Cancer 66: 109–113

    Article  PubMed  CAS  Google Scholar 

  • Snow GB, Annyas AA, van Slooten EA, Bartelink H, Hart AAM (1982) Prognostic factors of neck node metastasis. Clin Otolaryngol 7: 185–192

    Article  PubMed  CAS  Google Scholar 

  • Snow GB, Balm AJM, Arendse JW, Karim ABMF, Bartelink H, Waal I van der, Tiwari RM (1986) Prognostic factors in neck node metastases. In: Larson DL, Ballantyne AJ, Guillamondegni OM (eds) Cancer in the neck. Evaluation and treatment. MacMillan, New York, pp 53–63

    Google Scholar 

  • Spiro RH, Alfonso AE, Farr HW, Strong EW (1974) Cervical node metastases from epidermoid carcinoma of the oral cavity and oropharynx. A critical assessment of current staging. Am J Surg 128: 562–567

    Google Scholar 

  • Spiro RH, Huvos AG, Wong GY, Spiro JD, Gnecco CA, Strong EW (1986) Predictive value of tumour thickness in squamous carcinoma confined to the tongue and floor of the mouth. Am J Surg 152: 345–350

    Article  PubMed  CAS  Google Scholar 

  • Spiro JD, Spiro RH, Shah JP, Sessions RB, Strong EW (1988) Critical assessment of supraomohyoid neck dissection. Am J Surg 156: 286–289

    Article  PubMed  CAS  Google Scholar 

  • Stern WBR, Silver CE, Zeifer BA, Persky MS, Heller KS (1990) Computed tomography of the clinically negative neck. Head Neck 12: 109–113

    Article  PubMed  CAS  Google Scholar 

  • Stevens MH, Harnsberger HR, Mancuso AA, Davis RK, Johnson LP, Parkin JL (1985) Computed tomography of cervical lymph nodes: staging and management of head and neck cancer.Arch Otolaryngol 111: 735–739

    CAS  Google Scholar 

  • van den Brekel MWM, Stel HV, Castelijns JA, Nauta JJ, Waal I van der, Valk J, Meyer CJ, Snow GB (1990) Cervical lymph node metastases: assessment of radiologic criteria. Radiology 177: 379–384

    PubMed  Google Scholar 

  • van den Brekel MWM, Castelijns JA, Croll GA, Stel HV, Valk J, Waal I van der, Golding RP, Meyer CJLM, Snow GB (1991a) Magnetic resonance imaging vs palpation of cervical lymph node metastases. Arch Otolaryngol Head Neck Surg 117: 666–673

    Article  Google Scholar 

  • van den Brekel MWM, Castelijns JA, Stel HV, Luth WJ, Valk J, Waal I van der, Snow GB (1991b) Occult metastatic neck disease: detection with ultrasound and ultrasound-guided fine needle aspiration cytology. Radiology 180: 457–461

    PubMed  Google Scholar 

  • Vikram B, Strong EW, Shah JP, Spiro R (1984) Failure at distant sites following mutimodality treatment for advanced head and neck cancer. Head Neck Surg 6: 730–733

    Article  PubMed  CAS  Google Scholar 

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© 1994 Springer-Verlag Berlin Heidelberg

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Snow, G.B., van den Brekel, M.W.M., Leemans, C.R., Patel, P. (1994). Surgical Management of Cervical Lymph Nodes in Patients with Oral and Oropharyngeal Cancer. In: Pape, HD., Ganzer, U., Schmitt, G. (eds) Carcinoma of the Oral Cavity and Oropharynx. Recent Results in Cancer Research, vol 134. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84971-8_6

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  • DOI: https://doi.org/10.1007/978-3-642-84971-8_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84973-2

  • Online ISBN: 978-3-642-84971-8

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