Jothieswaran, K (2020) A Comprehensive study on Selective Neck Dissection in Measuring Outcome and Prognosis in Operable Oral Cavity Malignancy with N0 Neck Node. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Squamous cell carcinoma constitute the most common type of head and neck malignancy. Oral cavity malignancy accounts for 14% of all head and neck cancers. In the oral cavity, tongue is the most common subsite. Single most important prognostic factor in oral cavity cancer is cervical node metastasis.There is no reliable parameter to predict the occult metastasis. The aim is to study the rationale of selective neck dissection in Oral Cavity tumors with N0 Neck Node. To study the correlation of size, site, stage, grade and growth pattern of the tumor with rate of occult positivity of neck nodes. METHODS: Primary curative surgery according to the site of lesion and Selective Neck Dissection is done for all the patients. Primary tumor and Neck nodes separately classified and sent for histopathological examination and checked for occult positivity and observation of following criteria, Percentage of occult nodal metastasis, Which group of node involved commonly, Specific involvement of Level 2B node. RESULTS: A total of 30 patients were enrolled in our study. The incidence of occult ipsilateral neck nodal metastases in present study is around 23%. The incidence of Level IB node are 43%, IIA are 43%, and IIB was 14%. Higher T stage and an infiltrating pattern of growth of the Primary were the only significant predictive factors of higher Incidence of neck metastases among the factors analyzed in our study. CONCLUSION: Elective neck dissection is to be considered for treatment of all N0 necks in early oral cavity carcinoma. Level IIB must be included in the neck dissection specimen wherever tongue is the primary to achieve locoregional control and prevent recurrence. Patients undergoing elective neck dissection had a significantly better disease free and overall survival advantage.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221714004 |
| Uncontrolled Keywords: | Selective neck dissection, occult metastasis, squamous cell carcinoma, oral cavity malignancy. |
| Subjects: | MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Feb 2021 02:52 |
| Last Modified: | 15 Feb 2021 02:52 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14216 |
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