title: Neck dissection for oral squamous cell carcinoma: our experience and a review of the literature.
abstract: OBJECTIVE
  This article describes our experience with neck dissection in 10 patients with oral squamous cell carcinoma.
  
  
  METHODS
  Between January 2007 and October 2009, 10 patients underwent primary surgery for the treatment of squamous cell carcinoma of the oral cavity. For patients with N0 disease on clinical exam, selective neck dissection (SND [I-III]) was performed. In patients with palpable cervical metastases (N+), modified radical neck dissections were performed, except in one patient in whom SND (I-III) was performed. The histopathologic reports were reviewed to assess the surgical margins, the presence of extra-capsular spread, perineural invasion, and lymphatic invasion.
  
  
  RESULTS
  On histopathologic examination, positive soft tissue margins were found in three patients, and regional lymph node metastases were present in five of the ten patients. Perineural invasion was noted in five patients, and extra nodal spread was found in four patients. Regional recurrence was seen in two patients and loco-regional recurrence plus distant metastasis to the tibia was observed in one patient. During the study period, three patients died. Seven patients remain free of disease to date.
  
  
  CONCLUSIONS
  Histopathological evaluation provides important and reliable information for disease staging, treatment planning, and prognosis. The philosophy of neck dissection is evolving rapidly with regard to the selectivity with which at-risk lymph node groups are removed. The sample size in the present study is small, thus, caution should be employed when interpreting these results.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Himachal Dental College and Hospital, Sunder Nagar, India.
authors.forename: Pooja
authors.identifier: 0000-0003-1237-6067
authors.initials: P
authors.lastname: Rani
authors.affiliation: Department of Oral and Maxillofacial Surgery, HP Govt. Dental College and Hospital, Shimla, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Bhardwaj
authors.affiliation: Department of Anatomy, Lady Hardinge Medical College and Hospital, New Delhi, India.
authors.forename: Praveen Kumar
authors.identifier: 0000-0002-5729-1027
authors.initials: PK
authors.lastname: Dass
authors.affiliation: Department of Radiotherapy, Regional Cancer Centre, Shimla, India.
authors.forename: Manoj
authors.identifier: 0000-0001-9157-7195
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Department of Oral and Maxillofacial Surgery, Himachal Dental College and Hospital, Sunder Nagar, India.
authors.forename: Divye
authors.identifier: 0000-0002-1605-9790
authors.initials: D
authors.lastname: Malhotra
authors.affiliation: Department of Oral and Maxillofacial Surgery, HP Govt. Dental College and Hospital, Shimla, India.
authors.forename: Narottam Kumar
authors.identifier: 0000-0001-7768-0831
authors.initials: NK
authors.lastname: Ghezta
keywords: Neck dissection; Selective neck dissection; Squamous cell carcinoma