Volume 16, Number 3, September 2004
| | Clinical Management and Outcome of Neck Recurrence after Neck Dissection for Oral Squamous Cell Carcinoma |
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Wataru Kobayashi,1 Roh Fukui,1 Hisashi Sato,1 Hiroto Kimura,1 Qiang Liu1,2
1Department of Oral and Maxillofacial Surgery, Hirosaki University School of Medicine, Hirosaki, Japan, and 2Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
Abstract
Objective: To review the treatment for recurrence in the neck after neck dissection for oral squamous cell carcinoma and its outcome.
Patients and Methods: Seven patients with neck recurrence after neck dissection for oral squamous cell carcinoma without recurrence of the primary tumour were treated between January 1990 and December 2000. Records were reviewed for site and stage of the primary tumour, initial treatment, and pathological findings, site and time of presentation of neck recurrence, and outcome and prognosis after treatment.
Results: Tongue carcinoma was the primary site in 5 patients, floor of the mouth in 1 patient, and lower gingiva in 1 patient. Neck recurrence presented 7.5 months after the initial operation and was found at level 2 to level 5. Four patients underwent secondary surgery with or without adjuvant radiotherapy and chemotherapy. Two patients each had palliative radiotherapy and chemotherapy only. One patient was not fit for further treatment. Two patients remained alive at last follow-up of 30 months and 70 months, respectively. The other 5 patients lived for 2 to 16 months after the secondary treatment. The survival time for patients who accepted secondary surgery was 6 to 70 months in comparison to 2 to 4 months for patients who did not undergo secondary operation.
Conclusion: This study demonstrates that neck recurrence often occurs in patients with tongue carcinoma and may be found at any lymph node level. Surgical resection of recurrent neck lesions, if feasible, is an effective method and should be considered.
Key words: Oral cancer, Neck dissection, Neck neoplasms
Asian J Oral Maxillofac Surg 2004;16:153-159
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