Occult lymph node metastasis in lower lip cancers and approach to N0neck

Yıl 2002, Cilt: 9 Sayı: 1, 41 - 45, 03.01.2002

Sinan Kocatürk Nurettin Özdemir Ünsal Erkam Halit Uzun Aykut Babila Erkan Öztürk

Öz

Objectives: İn this study, we evaluated the inci- dence of occult lymph node metastasis and the approach to No necks in carcinoma of the lower lip.Patients and Methods: Sixty-eight patients who undervvent surgery for squamous celi carcinoma of the lower lip were monitored for a minimum period of three years. AH the patients were males mean age 54 years; range 36 to 69 years . Preoperatively, 15 and 53 patients had N+ and No necks, respectively. Depending on the tumor localization, unilateral or bilateral suprahy­ oid neck dissections were performed. Nine patients undervvent radical neck dissection follovving detection of metastasis on histopathologic examination.Results: Histopathologic examination revealed metastasis in four patients 4/15; 26% with N+ necks and in five patients 5/53; 9.4% with No necks. Four patients 6.7% developed late cervical lymph node metastasis at level 3. No evidence of neck disease was encountered in 93% of patients.Conclusion: Suprahyoid neck dissection appears to be effective in detecting occult lymph node metasta­ sis. With improved surgical and histopathologic techniques and consideration of skip metastasis, more aggressive treatment approaches may be employed and better survival rates maybe obtained.

Anahtar Kelimeler

Carcinoma, squamous cell/surgery, head and neck neoplasms/surgery, hyoid bone, lip neoplasms/ pathology/surgery, lymph node excision/methods, lymphatic metastasis, neoplasm recurrence, local, radical neck dissection, risk factors

Alt dudak kanserlerinde gizli lenf nodu metastazı oranları ve No boyna yaklaşım

Öz

Amaç: Bu çalıflmada alt dudak kanserli hastalardagizli lenf nodu metastazı varlığı ve N0boyunlara yaklaflım değerlendirildi. Hastalar ve Yöntemler: Alt dudakta skuamöz hücreli tümör nedeniyle ameliyat edilen ve en az üç yıltakip edilen 68 hasta çalıflmaya alındı. Hastaların tümü erkekti . Ameliyat öncesinde 15 hastada N+, 53 hastada N0boyun saptandı. Tümörün yerleflim yerine bağlı olarak tek yada iki taraflı suprahyoid boyun diseksiyonu SHBD yapıldı. Ameliyat sonrasındaki histopatolojik incelemede metastaz saptanan dokuz hastaya radikal boyun diseksiyonu uygulandı.Bulg u l a r : Ameliyat öncesinde N+olarak değerlendirilen hastaların dördünde 4/15; %26 , N0olarak değerlendirilen hastaların beflinde 5/53; %9.4 histopatolojik incelemede metastaz görüldü %13.2 . Dört hastada %6.7 , üçüncü seviyede geç metastaz geliflti. Hastaların %93’ünde boyunda hastalık bulgusu görülmedi. Son uç : Gizli metastazların saptanmasında SHBD’ninçok etkili olduğu görüldü. Uygulamaya bağlı yetersizliklerin histopatolojik kesit alınması veya cerrahi teknikile ilgili sorunlar veya skip metastaz varlığı giderilmesive primer tedavide daha agresif yaklaflımların uygulanmasıyla daha iyi sağkalım sonuçları sağlanabilir

Anahtar Kelimeler

Karsinom, skuamöz hücreli/cerrahi, bafl-boyun neoplazmları/cerrahi, hyoid kemiği, dudak neoplazmları/patoloji/cerrahi, lenf nodu eksizyonu/yöntem, lenfatik metastaz, neoplazm rekürensi, lokal, radikalboyun diseksiyonu, risk faktörleri

Kaynakça

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