Neck Dissection For Oral Squamous Cell Carcinoma

Objectives: Oral squamous cell carcinoma (OSCC) is the most frequent malignant tumors in oral-maxillofacial surgery. The predilections position contains tongue, cheek, gingival, mouth floor and lip mucosa. It appears variously such as ulcer, infiltration and lump. Biological behavior shows that it is easy to get neck lymph metastasis, but seldom haema metastasis. After neck metastasis, carcinoma will stay for a long period. So neck dissection is the essential process in radical cure of oral squamous cell carcinoma besides removal of primary lesion. It is about one hundred years since Crile and Martin adopt radical neck dissection (RND) and this classical surgery had made great progress in clinical therapeutic effect with various kinds of patients. In this article, we are trying to selecting rational approach for neck dissection by analyzing the relationship between clinical stage, different tissue and metastasis in 91 cases of oral squamous cell carcinoma.Methods: 91 previously untreated OSCC patients were included in the follow-up study All of them classified by various tissue, TNM (UICC,2002) and neck dissections to evaluate the optimization of therapy in order to investigate the best treatment of neck dissection.Results:1. Carcinoma of tongue ranked the most of these cases 30.8%. Carcinoma of gingival ranked 19.8%, cheek carcinoma ranked 16.4%, carcinoma of mouth floor ranked 12.1%, cheilocarcinomas ranked 11%, carcinoma of palate ranked 9.8%. The metastasis rate of OSCC was 11%.2. Lymph node pathologic positive rates were N0 8%,N1 14.8%. No significant difference between them.3.Recurrences occurred in 11%(10/91). The significant difference occurred during patients with untreated necks, FND class and RND class. It also occurred in the class with different stage of T. But no difference in N stages or parts.Conclusions: TNM classification is useful to estimate lymph metastasis application of different kinds of neck dissection. For patients of lips, gingival, mouth floor and palate SCC with T1, functional neck dissection is recommended. For patients of tongue and cheek SCC with T1, radical neck dissection is recommended. For patients of tongue, cheek, lip, gingival and mouth floor SCC with T2,T3, option with radical neck dissection with aid therapy is recommend.