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Indications and extent of elective neck dissection in patients with early stage oral and oropharyngeal carcinoma: nationwide survey in The Netherlands

Published online by Cambridge University Press:  08 March 2017

R de Bree*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
I van der Waal
Affiliation:
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
P Doornaert
Affiliation:
Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands
J A Werner
Affiliation:
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
J A Castelijns
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Philipps University Marburg, Germany
C R Leemans
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
*
Address for correspondence: Dr Remco de Bree, Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Fax: +31 20 4443688 E-mail: r.bree@vumc.nl

Abstract

Background:

Different strategies are available for the management of patients with early (i.e. tumour stage one or two) oral or oropharyngeal carcinoma and a clinically negative neck.

Material and methods:

In 2006, a questionnaire was sent to the eight head and neck cancer centres of the Dutch Head and Neck Oncology Cooperative Group. This questionnaire covered: the factors influencing the decision to perform an elective neck dissection; the neck staging procedure; and the types of neck dissection undertaken.

Results:

All eight questionnaires were returned completed. Respondents indicated that the site (n = 6), size (n = 7) and thickness (n = 6) of the primary tumour were important in decisions regarding elective neck dissection. Ultrasound-guided fine needle aspiration cytology was the most frequently used diagnostic technique (n = 7). Depending on the site and stage of the primary tumour presented, in the different cases 3–7 of the centres would perform an elective neck dissection. Selective neck dissections (i.e. levels I to III/IV) were more frequently performed than modified radical neck dissections.

Conclusion:

There was no uniformity regarding management of the clinically negative neck in patients with early stage oral and oropharyngeal carcinoma, within The Netherlands.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Leemans, CR, Tiwari, R, Nauta, JJ, Van der Waal, I, Snow, GB. Regional lymph node involvement and its significance in the development of distant metastases in head and neck cancer. Cancer 1993;71:452–63.0.CO;2-B>CrossRefGoogle Scholar
2 Snow, GB, Annyas, AA, van Slooten, EA, Bartelink, H, Hart, AA. Prognostic factors of neck node metastases. Clin Otolaryngol 1982;7:182–92CrossRefGoogle Scholar
3 Ali, S, Tiwari, RM, Snow, GB. False positive and false negative neck nodes. Head Neck Surg 1985;8:7882CrossRefGoogle ScholarPubMed
4 Dijkstra, PU, Wilgen, PC, van Buijs, RP, Brendeke, W, de Goede, CJ, Kerst, A et al. Incidence of shoulder pain after neck dissection: a clinical explorative study for risk factors. Head Neck 2001;23:947–53CrossRefGoogle ScholarPubMed
5 Mira, E, Benazzo, M, Rossi, V, Zanoletti, E. Efficacy of selctive lymph node dissection in clinically negative neck. Otolaryngol Head Neck Surg 2002;127:279–83CrossRefGoogle Scholar
6 Dünne, AA, Folz, BJ, Kuropkat, C, Werner, JA. Extent of surgical intervention in case of N0 neck in head and neck cancer patients: an analysis of data collection of 39 hospitals. Eur Arch Otorhinolaryngol 2004;261:295303CrossRefGoogle ScholarPubMed
7 Nederlandse Werkgroep Hoofd-Halstumoren. Guidelines oral and oropharyngeal carcinoma. Alphen aan den Rijn: Van Zuiden Communications, 2004Google Scholar
8 Werning, JW, Heard, D, Pagano, C, Khuder, S. Elective management of the clinical negative neck by otolaryngologists in patients with oral tongue cancer. Arch Otolaryngol Head Neck Surg 2003;129:83–8CrossRefGoogle Scholar
9 Kligerman, J, Lima, RA, Soares, JR, Prado, L, Dias, FL, Freitas, EQ et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. Am J Surg 1994:168:391–4CrossRefGoogle ScholarPubMed
10 Sparano, A, Weinstein, G, Chalian, A, Yodul, M, Weber, R. Multivariate predictors of occult neck metastasis in early oral tongue cancer. Otolaryngol Head Neck Surg 2004;131:472–6CrossRefGoogle ScholarPubMed
11 Kurokawa, H, Yamashita, Y, Takeda, S, Zhang, M, Fukuyama, H, Takahashi, T. Risk factors for late cervical lymph node metastases in patients with stage I and II carcinoma of the tongue. Head Neck 2002;24:731–6CrossRefGoogle Scholar
12 O'Brien, CJ, Taynor, SJ, McNeil, E, McMahon, JD, Chaplin, JM. The use of clinical criteria alone in the management of the clinically negative neck among patients with squamous cell carcinoma of the oral cavity and oropharynx. Arch Otolaryngol Head Neck Surg 2000;126:360–5CrossRefGoogle Scholar
13 De Zinis, LOR, Bolzini, A, Piazza, C, Nicolai, P. Prevalence and localization of nodal metastases in squamous cell carcinoma of the oral cavity: role and extension of neck dissection. Eur Arch Otorhinolaryngol 2006;263:1131–5CrossRefGoogle ScholarPubMed
14 Sheahan, P, O'Keane, C, Sheahan, JN, O'Dwyer, TP. Effect of tumour thickness and other factors on the risk of regional disease and treatment of the N0 neck in early oral squamous cell carcinoma. Clin Otolaryngol 2003;28:461–71CrossRefGoogle Scholar
15 Lim, SC, Zhang, S, Ishii, G, Endoh, Y, Kodama, K, Miyamoto, S et al. Predictive markers for late cervical metastasis in stage I and II invasive squamous cell carcinoma of the oral tongue. Clin Cancer Res 2004;10:166–72CrossRefGoogle Scholar
16 Shingaki, S, Suzuki, I, Nakajima, T, Kawasaki, T. Evaluation of histopathological parameters in predicting cervical lymph node metastasis of oral and oropharyngeal carcinomas. Oral Surg Oral Med Oral Pathol 1988;66:683–8CrossRefGoogle Scholar
17 O'Brien, CJ, Lauer, CS, Fredericks, S, Clifford, AR, McNeil, EB, Baia, JS et al. Tumor thickness influences prognosis of T1 and T2 oral cavity cancer – but what thickness? Head Neck 2003;25:937–45CrossRefGoogle ScholarPubMed
18 Fakih, AR, Rao, RS, Borges, AM, Patel, AR. Elective versus therapeutic neck dissection in early carcinoma of the tongue. Am J Surg 1989;158:309–13CrossRefGoogle Scholar
19 Takes, RP, Baatenburg de Jong, RJ, Alles, MJR, Meeuwis, CA, Marres, HAM, Knegt, PPM et al. Markers for nodal metastasis in head and neck squamous cell cancer. Arch Otolaryngol Head Neck Surg 2002;128:512–18CrossRefGoogle ScholarPubMed
20 Roepman, P, Wessels, LFA, Kettelarij, N, Kemmeren, P, Miles, AJ, Lijnzaad, P et al. An expression profile for diagnosis of lymph node metastases from primary head and neck squamous cell carcinomas. Nature Genetics 2005;37:182–6CrossRefGoogle ScholarPubMed
21 Van den Brekel, MWM, Castelijns, JA, Stel, HV, Golding, RP, Meyer, CJ, Snow, GB. Modern imaging techniques and ultrasound guided aspiration cytology for the assessment of the neck node metastases: a prospective comparative study. Eur Arch Otorhinolaryngol 1993;250:1117CrossRefGoogle ScholarPubMed
22 Brouwer, J, de Bree, R, Comans, EFI, Castelijns, JA, Hoekstra, OS, Leemans, CR. Positron emission tomography using [18F]fluorodeoxyglucose (FDG-PET) in the clinically negative neck: is it likely to be superior? Eur Arch Otorhinolaryngol 2004;261:479–89CrossRefGoogle Scholar
23 Wensing, BM, Vogel, WV, Marres, HAM, Merkx, MAW, Postema, EJ, Oyen, WJG et al. FDG-PET in the clinically negative neck in oral squamous cell carcinoma. Laryngoscope 2006;116:809–13CrossRefGoogle ScholarPubMed
24 Righi, PD, Kopecky, KK, Caldemeyer, KA, Ball, VA, Weisberger, EC, Radpour, S. Comparison of ultrasound-fine needle aspiration and computed tomography in patients undergoing elective neck dissection. Head Neck 1997;19:601–103.0.CO;2-B>CrossRefGoogle ScholarPubMed
25 Takes, RP, Righi, P, Meeuwis, CA, Manni, JJ, Knegt, P, Marres, HAM et al. The value of ultrasound with ultrasound-guided fine-needle aspiration biopsy compared to computed tomography in the detection of regional metastases in the clinically negative neck. Int J Radiat Oncol Biol Phys 1998;40:1027–32CrossRefGoogle ScholarPubMed
26 Koch, WM, Choti, MA, Civelek, C, Eisele, DW, Saunders, JR. Gamma probe-directed biopsy of the sentinel lymph node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 1998;124:455–9CrossRefGoogle ScholarPubMed
27 Alex, JC, Sasaki, CT, Krag, DN, Wenig, B, Pyle, PB. Sentinel lymph node radiolocalization in head and neck squamous cell carcinoma. Laryngoscope 2000;110:198203CrossRefGoogle ScholarPubMed
28 Shoaib, T, Soutar, DS, MacDonald, DG, Camilleri, IG, Dunaway, DJ, Gray, HW et al. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer 2001;91:2077–833.0.CO;2-E>CrossRefGoogle ScholarPubMed
29 Stoeckli, SJ, Steinert, H, Pfaltz, M, Schmid, S. Sentinel node evaluation in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 2001;125:221–6CrossRefGoogle ScholarPubMed
30 Ross, GL, Shoaib, T, Soutar, DS, MacDonald, DG, Camilleri, IG, Bessent, RG et al. The First International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer and adoption of a multicenter trial protocol. Ann Surg Oncol 2002;9:406–10CrossRefGoogle ScholarPubMed
31 Dias, FL, Kligerman, J, Matos de Sã, G, Arcuri, RA, Freita, EQ, Farias, T et al. Elective neck dissection versus observation in stage I squamous cell carcinoma of the tongue and floor of mouth. Otolaryngol Head Neck Surg 2001;125:23–9CrossRefGoogle Scholar
32 Capote, A, Escorial, V, Muňoz-Guerra, MF, Rodríguez-Campo, FJ, Gamallo, C, Naval, L. Elective neck dissection in early-state oral squamous cell carcinoma – does it influence recurrence and survival? Head Neck 2007;29:311CrossRefGoogle Scholar
33 Yuen, APW, Wei, WI, Wong, YM, Tang, KC. Elective neck dissection versus observation in the treatment of early oral tongue carcinoma. Head Neck 1997;19:583–83.0.CO;2-3>CrossRefGoogle ScholarPubMed
34 Yii, NW, Patel, SG, Rhys-Evans, PH, Breach, NM. Management of the N0 neck in early cancer of the tongue. Clin Otolaryngol 1999;24:75–9CrossRefGoogle Scholar
35 August, M, Gianetti, K. Elective neck irradiation versus observation of the clinically negative neck of patients with oral cancer. J Oral Maxillofac Surg 1996;54:1050–5CrossRefGoogle ScholarPubMed
36 Keski-Säntti, H, Atula, T, Törnwall, J, Koivunen, P, Mäkitie, A. Elective neck treatment versus observation in patients with T1/T2 N0 squamous cell carcinoma of the oral tongue. Oral Oncol 2006;42:96101CrossRefGoogle ScholarPubMed
37 McGuirt, WF, Johnson, JT, Myers, EN, Tothfeosl, R, Wagner, R. Floor of mouth carcinoma; management of the clinically negative neck. Arch Otolaryngol Head Neck Surg 1995;12:278–82CrossRefGoogle Scholar
38 Kowalski, LP. Results of salvage treatment of the neck in patients with oral cancer. Arch Otolaryngol Head Neck Surg 2002;128:5862CrossRefGoogle ScholarPubMed
39 Vandenbrouck, C, Sancho-Garnier, H, Chassagen, D, Saravane, D, Cachin, Y, Micheau, C. Elective versus therapeutic neck dissection in epidermoid carcinoma of the oral cavity: results of a randomized clinical trial. Cancer 1980;46:386–903.0.CO;2-9>CrossRefGoogle ScholarPubMed
40 Franceschi, D, Gupta, R, Spiro, RH, Shah, JP. Improved survival in the treatment of squamous cell carcinoma of the oral tongue. Am J Surg 1993;166:360–5CrossRefGoogle ScholarPubMed
41 Khafif, A, Lopez-Garza, JR, Medina, JE. Is dissection of level IV necessary in patients with T1-T3N0 tongue cancer? Laryngoscope 2001;111:1088–90CrossRefGoogle Scholar
42 Duvvuri, U, Simental, AA, D'Angelo, G, Johnson, JT, Ferris, RL, Gooding, W et al. Elective neck dissection and survival in patients with squamous cell carcinoma of the oral cavity and oropharynx. Laryngoscope 2004;114:2228–34CrossRefGoogle ScholarPubMed
43 Nieuwenhuis, EJC, Castelijns, JA, Pijpers, R, van den Brekel, MWM, Brakenhoff, RH, van der Waal, I et al. Wait-and-see policy for the N0 neck in early stage oral and oropharyngeal SCC using ultrasonography-guided cytology: is there a role for identification of the sentinel node? Head Neck 2002;24:282–9CrossRefGoogle Scholar
44 Medina, JE, Byers, RM. Supraomohyoid neck dissection: rationale, indications and surgical technique. Head Neck 1989;11:111–22CrossRefGoogle ScholarPubMed
45 Yu, S, Li, J, Li, Z, Zhang, W, Zhao, J. Efficacy of supraomohyoid neck dissection in patients with oral squamous cell carcinoma and negative neck. Am J Surg 2006;191:94–9CrossRefGoogle ScholarPubMed
46 Majoufre, C, Faucher, A, Laroche, C, De Bonfils, C, Siberchicot, F, Renaud-Salis, JL et al. Supraomohyoid neck dissection in cancer of the oral cavity. Am J Surg 1999;178:73–7CrossRefGoogle ScholarPubMed
47 Kerrebijn, JD, Freeman, JL, Irish, JC, Witterick, IJ, Brown, DH, Rotstein, LE et al. Supraomohyoid neck dissection: is it diagnostic or therapeutic? Head Neck 1999;21:39423.0.CO;2-4>CrossRefGoogle ScholarPubMed
48 Byers, RM, Weber, RS, Andrews, T, McGill, D, Kare, R, Wolf, P. Frequency and therapeutic implications of “skip metastases” in the neck from squamous cell carcinoma of the oral tongue. Head Neck 1997;19:14193.0.CO;2-Y>CrossRefGoogle ScholarPubMed
49 Shah, JP, Candela, FC, Poddar, AK. The pattern of cervical lymph node metastases from squamous cell carcinoma of the oral cavity. Cancer 1990;66:109–133.0.CO;2-A>CrossRefGoogle Scholar
50 Dias, FL, Kima, RA, Kligerman, J, Farias, TP, Soares, JRN, Manfro, G et al. Relevance of skip metastases for squamous cell carcinoma of the oral tongue and floor of mouth. Otolaryngol Head Neck Surg 2006;134:460–5CrossRefGoogle Scholar
51 Wing, AP, Lam, KY, Chan, ACL, Wei, WI, Lam, LK, Ho, WK et al. Clinicopathological analysis of elective neck dissection for N0 neck of early oral tongue carcinoma. Am J Surg 1999;177:90–2Google Scholar
52 Ferlito, A, Mannara, GM, Rinaldo, A, Politi, M, Robiony, M, Costa, F. Is extended selective supraomohyoid neck dissection indicated for treatment of oral cancer with clinically negative neck? Acta Otolaryngol 2000;120:792–5CrossRefGoogle ScholarPubMed
53 Crean, SJ, Hoffman, A, Potts, J, Fardy, MJ. Reduction of occult metastatic disease by extension of the supraomohyoid neck dissection to include level IV. Head Neck 2003;25:758–62CrossRefGoogle ScholarPubMed
54 Van den Hooghen, FJA, Manni, JJ. Value of the supraomohyoid neck dissection with frozen section analysis as a staging procedure in the clinically negative neck in squamous cell carcinoma of the oral cavity. Eur Arch Otorhinolaryngol 1992;249:144–8CrossRefGoogle Scholar
55 Youssef, E, Chuba, P, Salib, N, Yoo, GH, Penagaricano, J, Ezzat, W et al. Pathological distribution of positive lymph nodes in patients with clinically and radiologically N0 oropharyngeal carcinoma: implications for IMRT treatment planning. Cancer J 2005;11:412–16CrossRefGoogle ScholarPubMed
56 Vartanian, JG, Pontes, E, Agra, IM, Campos, OD, Gonçalves-Filho, , Carvalho, AL et al. Distribution of metastatic lymph nodes in oropharyngeal carcinoma and its implications for elective treatment of the neck. Arch Otolaryngol Head Neck Surg 2003;129:729–32CrossRefGoogle Scholar
57 Paleri, V, Kumar Subramaniam, S, Ozeer, N, Rees, G, Krishnan, S. Dissection of the submuscular recess (sublevel IIb) in squamous cell carcinoma of the upper aerodigestive tract: prospective study and review of the literature. Head Neck 2008;30:194200CrossRefGoogle ScholarPubMed
58 Werner, JA. Selective sentinel lymphadenectomy for head and neck squamous cell carcinoma. Cancer Treat Res 2005;127:187206CrossRefGoogle ScholarPubMed
59 Zbären, P, Nuyens, M, Caversaccio, M, Stauffer, E. Elective neck dissection for carcinomas of the oral cavity: occult metastases, neck recurrence, and adjuvant treatment of pathologically positive necks. Am J Surg 2006;191:756–60CrossRefGoogle ScholarPubMed
60 Lim, YC, Lee, JS, Koo, BS, Kim, SH, Kim, YH, Choi, EC. Treatment of contralateral N0 neck in early squamous cell carcinoma of the oral tongue: elective neck dissection versus observation. Laryngoscope 2006;116:461–5CrossRefGoogle ScholarPubMed
61 Leemans, CR, Tiwari, R, Nauta, JJ, Snow, GB. Discontinuous vs in-continuity dissection in carcinoma of the oral cavity. Arch Otolaryngol Head Neck Surg 1991;117:1003–6CrossRefGoogle ScholarPubMed
62 Chiesa, F, Tradati, N, Calabrese, L. Sentinel node biopsy, lymphatic pattern and selective neck dissection in oral cancer. Oral Dis 2001;7:317–18CrossRefGoogle ScholarPubMed
63 Ferlito, A, Shaha, AR, Rinaldo, A. The incidence of lymph node metastases in patients with pathologically stages N0 in cancer of the oral cavity and oropharynx. Oral Oncol 2002;38:35CrossRefGoogle Scholar
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Indications and extent of elective neck dissection in patients with early stage oral and oropharyngeal carcinoma: nationwide survey in The Netherlands
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