Radical versus supraomohyoid neck dissection in the treatment of squamous cell carcinoma of the inferior level of the mouth.
The therapeutic paradigm for neck metastasis of squamous cell carcinoma (SCC) in the lower level of the mouth has changed due to survival.


OBJECTIVE
A comparative study between radical (RND) versus selective neck dissection (SND).


METHODS
An analysis of mouth SCC in the lower level of the mouth in 460 files from the Head & Neck and ORL Department of the Heliopolis Hospital, from 1978 to 2002. In the RND the metastathic rate in levels IV and V was assessed; in the SND the presence and site of recurrence was identified. The chi square test with the Yates correction was the chosen statistical method.


RESULTS
In the RND the metastatic rates were 5.8% (level IV) and 4.6% (level V) for cNO cases, and 9.9% (level IV) and 5.9% (level V) for cN+ cases; for level I only the rates were 11.0% for cNO cases and 5.5% for cN+ cases. In the SND the number of recurrences was 4 (4.1%) in 97 neck dissections (pNO) and 2 (10%) in 20 neck dissections (pN+). There was no advantage in using radiation compared to non-irradiated cases (5.6% and 5.7%).


CONCLUSIONS
The SND may be used for SCC of the lower level of the mouth.
Rapoport
Abrão
A
Head & Neck Surgery Department, Heliopolis Hospital, Hosphel/SP, Brazil.
Ortellado
Daniel Kanabben
DK
Amar
Ali
A
Lehn
Carlos Neutzling
CN
Dedivitis
Rogério Aparecido
RA
Perez
Ricardo Salinas
RS
Rodrigues
Helen Mara
HM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies