IIb or not IIb” – The Necessity of Dissection in Patients with Oral Squamous Cell Carcinoma
Abstract The necessary extent of cervical dissection in oral squamous cell carcinoma (OSCC) is still under discussion. Due to its anatomical properties Robins level IIb has a special role in neck dissection. This study focuses on the lymph node metastatic behaviour of OSCC in level IIb and evaluates...
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| Veröffentlicht in: | Journal of cranio-maxillo-facial surgery 2016-10, Vol.44 (10), p.1733-1736 |
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| creator | Bartella, Alexander K Kloss-Brandstätter, Anita, MD, PhD Kamal, Mohammad, MD, DMD Teichmann, Jan, MD, DMD Modabber, Ali, MD, DMD, PhD Hölzle, Frank, MD, DMD, PhD Lethaus, Bernd, MD, DMD, PhD |
| description | Abstract The necessary extent of cervical dissection in oral squamous cell carcinoma (OSCC) is still under discussion. Due to its anatomical properties Robins level IIb has a special role in neck dissection. This study focuses on the lymph node metastatic behaviour of OSCC in level IIb and evaluates its worth of dissection. 183 consecutive patients with OSCC were retrospectively screened for age, gender, TNM classification, cancer stage (after UICC), tumour localization, tumour infiltrations depth, and affected cervical lymph node levels. Associations between lymph node metastases and the above-mentioned characteristics were evaluated using Pearson’s chi square test and Spearman’s rho correlation analyses. Metastases in level IIb were seen in only 3.3% of all patients, and none of these metastases were an exclusive metastasis. Lymph node metastases most likely occurred in levels I and IIa at ipsilateral sites, and metastases were significantly related to tumour size (p |
| doi_str_mv | 10.1016/j.jcms.2016.08.003 |
| format | Article |
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Due to its anatomical properties Robins level IIb has a special role in neck dissection. This study focuses on the lymph node metastatic behaviour of OSCC in level IIb and evaluates its worth of dissection. 183 consecutive patients with OSCC were retrospectively screened for age, gender, TNM classification, cancer stage (after UICC), tumour localization, tumour infiltrations depth, and affected cervical lymph node levels. Associations between lymph node metastases and the above-mentioned characteristics were evaluated using Pearson’s chi square test and Spearman’s rho correlation analyses. Metastases in level IIb were seen in only 3.3% of all patients, and none of these metastases were an exclusive metastasis. Lymph node metastases most likely occurred in levels I and IIa at ipsilateral sites, and metastases were significantly related to tumour size (p<0.01) and the infiltration of lymph vessels (p<0.001). The locations of primary cancer sites in metastatic disease were the soft palate, alveolar crest of the lower jaw and buccal mucosa. Lymph node metastases of OSCC in level IIb remain rare, especially as exclusive metastases and in clinically N-negative necks. The findings of our study support the hypothesis of sparing neck dissection in level IIb in cases of clinically negative necks.</description><identifier>ISSN: 1010-5182</identifier><identifier>EISSN: 1878-4119</identifier><identifier>DOI: 10.1016/j.jcms.2016.08.003</identifier><identifier>PMID: 27613138</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Dentistry ; Female ; Humans ; Level II ; Lymph node ; Lymphatic Metastasis ; Male ; Metastasis ; Middle Aged ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Neck dissection ; Neck Dissection - statistics & numerical data ; Neoplasm Staging ; OSCC ; Retrospective Studies ; Surgery ; Treatment Outcome</subject><ispartof>Journal of cranio-maxillo-facial surgery, 2016-10, Vol.44 (10), p.1733-1736</ispartof><rights>European Association for Cranio-Maxillo-Facial Surgery</rights><rights>2016 European Association for Cranio-Maxillo-Facial Surgery</rights><rights>Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-42a9c7cb92cd6697ff57d261c93d8da254c0648734712a126177de8df948334e3</citedby><cites>FETCH-LOGICAL-c411t-42a9c7cb92cd6697ff57d261c93d8da254c0648734712a126177de8df948334e3</cites><orcidid>0000-0002-3545-1341</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1010518216301688$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27613138$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bartella, Alexander K</creatorcontrib><creatorcontrib>Kloss-Brandstätter, Anita, MD, PhD</creatorcontrib><creatorcontrib>Kamal, Mohammad, MD, DMD</creatorcontrib><creatorcontrib>Teichmann, Jan, MD, DMD</creatorcontrib><creatorcontrib>Modabber, Ali, MD, DMD, PhD</creatorcontrib><creatorcontrib>Hölzle, Frank, MD, DMD, PhD</creatorcontrib><creatorcontrib>Lethaus, Bernd, MD, DMD, PhD</creatorcontrib><title>IIb or not IIb” – The Necessity of Dissection in Patients with Oral Squamous Cell Carcinoma</title><title>Journal of cranio-maxillo-facial surgery</title><addtitle>J Craniomaxillofac Surg</addtitle><description>Abstract The necessary extent of cervical dissection in oral squamous cell carcinoma (OSCC) is still under discussion. Due to its anatomical properties Robins level IIb has a special role in neck dissection. This study focuses on the lymph node metastatic behaviour of OSCC in level IIb and evaluates its worth of dissection. 183 consecutive patients with OSCC were retrospectively screened for age, gender, TNM classification, cancer stage (after UICC), tumour localization, tumour infiltrations depth, and affected cervical lymph node levels. Associations between lymph node metastases and the above-mentioned characteristics were evaluated using Pearson’s chi square test and Spearman’s rho correlation analyses. Metastases in level IIb were seen in only 3.3% of all patients, and none of these metastases were an exclusive metastasis. Lymph node metastases most likely occurred in levels I and IIa at ipsilateral sites, and metastases were significantly related to tumour size (p<0.01) and the infiltration of lymph vessels (p<0.001). The locations of primary cancer sites in metastatic disease were the soft palate, alveolar crest of the lower jaw and buccal mucosa. Lymph node metastases of OSCC in level IIb remain rare, especially as exclusive metastases and in clinically N-negative necks. The findings of our study support the hypothesis of sparing neck dissection in level IIb in cases of clinically negative necks.</description><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Dentistry</subject><subject>Female</subject><subject>Humans</subject><subject>Level II</subject><subject>Lymph node</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Neck dissection</subject><subject>Neck Dissection - statistics & numerical data</subject><subject>Neoplasm Staging</subject><subject>OSCC</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1010-5182</issn><issn>1878-4119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAURS1ERUvhB1ggL9kk-NmZ2JEQEhoojFS1SC1ry2O_qA5J3NoJaHb9h675uX5JHU1hwaIrX8n3Xd13HiFvgJXAoH7flZ0dUsmzLpkqGRPPyBEoqYoKoHmeNQNWrEDxQ_IypY4xVjPVvCCHXNYgQKgjojebLQ2RjmGiWd7f_qH3t3f08grpGVpMyU87Glr62aeEdvJhpH6k383kcZwS_e2nK3oeTU8vbmYzhDnRNfY9XZto_RgG84octKZP-PrxPSY_Tr5crr8Vp-dfN-tPp4XNXaei4qax0m4bbl1dN7JtV9LxGmwjnHKGryrL6kpJUUngBvKPlA6Va5tKCVGhOCbv9rnXMdzMmCY9-GRzFTNibqVBVSAbzgXLVr632hhSitjq6-gHE3camF7A6k4vYPUCVjOlM9g89PYxf94O6P6N_CWZDR_2Bsxb_vIYdbKZkUXnYwanXfBP53_8b9z2fvTW9D9xh6kLcxwzPw06cc30xXLa5bJQi5yilHgAEEqeQg</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Bartella, Alexander K</creator><creator>Kloss-Brandstätter, Anita, MD, PhD</creator><creator>Kamal, Mohammad, MD, DMD</creator><creator>Teichmann, Jan, MD, DMD</creator><creator>Modabber, Ali, MD, DMD, PhD</creator><creator>Hölzle, Frank, MD, DMD, PhD</creator><creator>Lethaus, Bernd, MD, DMD, PhD</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3545-1341</orcidid></search><sort><creationdate>20161001</creationdate><title>IIb or not IIb” – The Necessity of Dissection in Patients with Oral Squamous Cell Carcinoma</title><author>Bartella, Alexander K ; Kloss-Brandstätter, Anita, MD, PhD ; Kamal, Mohammad, MD, DMD ; Teichmann, Jan, MD, DMD ; Modabber, Ali, MD, DMD, PhD ; Hölzle, Frank, MD, DMD, PhD ; Lethaus, Bernd, MD, DMD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-42a9c7cb92cd6697ff57d261c93d8da254c0648734712a126177de8df948334e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Dentistry</topic><topic>Female</topic><topic>Humans</topic><topic>Level II</topic><topic>Lymph node</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Neck dissection</topic><topic>Neck Dissection - statistics & numerical data</topic><topic>Neoplasm Staging</topic><topic>OSCC</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bartella, Alexander K</creatorcontrib><creatorcontrib>Kloss-Brandstätter, Anita, MD, PhD</creatorcontrib><creatorcontrib>Kamal, Mohammad, MD, DMD</creatorcontrib><creatorcontrib>Teichmann, Jan, MD, DMD</creatorcontrib><creatorcontrib>Modabber, Ali, MD, DMD, PhD</creatorcontrib><creatorcontrib>Hölzle, Frank, MD, DMD, PhD</creatorcontrib><creatorcontrib>Lethaus, Bernd, MD, DMD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cranio-maxillo-facial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bartella, Alexander K</au><au>Kloss-Brandstätter, Anita, MD, PhD</au><au>Kamal, Mohammad, MD, DMD</au><au>Teichmann, Jan, MD, DMD</au><au>Modabber, Ali, MD, DMD, PhD</au><au>Hölzle, Frank, MD, DMD, PhD</au><au>Lethaus, Bernd, MD, DMD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>IIb or not IIb” – The Necessity of Dissection in Patients with Oral Squamous Cell Carcinoma</atitle><jtitle>Journal of cranio-maxillo-facial surgery</jtitle><addtitle>J Craniomaxillofac Surg</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>44</volume><issue>10</issue><spage>1733</spage><epage>1736</epage><pages>1733-1736</pages><issn>1010-5182</issn><eissn>1878-4119</eissn><abstract>Abstract The necessary extent of cervical dissection in oral squamous cell carcinoma (OSCC) is still under discussion. Due to its anatomical properties Robins level IIb has a special role in neck dissection. This study focuses on the lymph node metastatic behaviour of OSCC in level IIb and evaluates its worth of dissection. 183 consecutive patients with OSCC were retrospectively screened for age, gender, TNM classification, cancer stage (after UICC), tumour localization, tumour infiltrations depth, and affected cervical lymph node levels. Associations between lymph node metastases and the above-mentioned characteristics were evaluated using Pearson’s chi square test and Spearman’s rho correlation analyses. Metastases in level IIb were seen in only 3.3% of all patients, and none of these metastases were an exclusive metastasis. Lymph node metastases most likely occurred in levels I and IIa at ipsilateral sites, and metastases were significantly related to tumour size (p<0.01) and the infiltration of lymph vessels (p<0.001). The locations of primary cancer sites in metastatic disease were the soft palate, alveolar crest of the lower jaw and buccal mucosa. Lymph node metastases of OSCC in level IIb remain rare, especially as exclusive metastases and in clinically N-negative necks. The findings of our study support the hypothesis of sparing neck dissection in level IIb in cases of clinically negative necks.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>27613138</pmid><doi>10.1016/j.jcms.2016.08.003</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-3545-1341</orcidid></addata></record> |
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| subjects | Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Dentistry Female Humans Level II Lymph node Lymphatic Metastasis Male Metastasis Middle Aged Mouth Neoplasms - pathology Mouth Neoplasms - surgery Neck dissection Neck Dissection - statistics & numerical data Neoplasm Staging OSCC Retrospective Studies Surgery Treatment Outcome |
| title | IIb or not IIb” – The Necessity of Dissection in Patients with Oral Squamous Cell Carcinoma |
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