Neck Dissection Indications in Lower Lip Squamous Cell Carcinoma Cases: Our Experience in 96 Cases

Objective: Squamous cell carcinoma (SCC) is the most common lip carcinoma and nodal status is the single most important prognostic factor. Though surgery is the first choice of treatment in early-stage cases, elective neck dissection to treat an eventual occult metastasis is still a matter of discussion. Methods: A total of 96 patients with lower lip SCC who were operated on in a single clinic between January 2005 and July 2017 were included in this study. Patients who did and did not undergo elective neck dissection after tumor resection according to risk and nodal status were studied in terms of age, gender, tumor size, and neck dissection type. Results: Among 96 patients, 74 were classified as T1-2N0 according to the American Joint Committee on Cancer staging system, and 30 underwent elective neck dissection. Among these 30 patients, 6 were diagnosed with metastasis. A total of 51 of the 96 members of the study group underwent elective supraomohyoid neck dissection. In all, 23 patients were diagnosed with metastasis. Conclusion: Lower lip SCC is a cancer with a relatively good prognosis, but regional lymph node metastasis decreases the survival rate substantially. In selected cases, staging the tumor via supraomohyoid neck dissection or sentinel lymph node biopsy is adequate to detect occult metastasis and prevent late lymph node metastasis.

Alt Dudak Skuamöz Hücreli Karsinom Olgularında Boyun Diseksiyonu Endikasyonları: 96 Olgu Üzerindeki Klinik Tecrübelerimiz

Amaç: Lenf nodu tutulumu, alt dudak skuamöz hücreli karsinom olgularındaki en önemli prognostik faktördür. Erken evrelerde cerrahi ilk seçenek olmasına rağmen, okkült metastazları saptamak için de olsa elektif lenf nodu diseksiyonu yapılması hala tartışma konusudur. Gereç ve Yöntem: Bu çalışmaya Ocak 2005 ve Temmuz 2017 yılları arasında ameliyat edilen 96 alt dudak skuamöz hücreli karsinom olgusu alındı. Tümör rezeksiyonu sonrası, risk ve lenf nodu tutulumuna göre boyun diseksiyonu yapılmış olan veya yapılmamış olan olgular; yaş, cinsiyet, tümör büyüklüğü ve yapılan boyun diseksiyonu tipine göre incelendi. Bulgular: Ameliyat edilenlerde 74 olgu T1-2N0 evresinde idi ve bunların 30’una elektif lenf nodu diseksiyonu uygulandı ve bu 30 hastanın altısında metastaz saptandı. Olguların 51’ine elektif lenf nodu diseksiyonu uygulandı ve bunların 23’ünde metastaz saptandı. Sonuç: Alt dudak skuamöz hücreli karsinomları relatif olarak iyi prognoza sahip olmasına rağmen, rejyonel lenf nodu metastazı sağkalım oranını belirgin şekilde düşürür. Okkült metastazları saptamak ve geç dönem lenf nodu metastazlarını önlemek için, seçilmiş olgularda sentinel lenf nodu biyopsisi ya da supraomohiyoid lenf nodu diseksiyonları akılda tutulması gereken işlemlerdir.

Kaynakça

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

1.1b380

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