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Neck recurrence after level I–IV or I–III selective neck dissection in the management of the clinically N0 neck in patients with oral squamous cell carcinoma

Authors

  • Mandeep S. Bajwa MBChB, MFDSRCS,

    Corresponding author
    1. School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
    • School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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  • Roddy McMillan MBChB, MFDSRCS,

    1. School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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  • Owais Khattak MBChB, MFDSRCS,

    1. School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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  • Mathew Thomas MBChB, MFDSRCS,

    1. School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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  • Ojas P. Krishnan MDS MFDSRCPS,

    1. School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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  • Keith Webster FDSRCS, FRCS

    1. Department of Oral and Maxillofacial Surgery, University Hospital Birmingham NHS Trust, Birmingham, United Kingdom
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Abstract

Background

Controversy remains regarding extending the level I–III selective neck dissection (SND) to include level IV in the management of the clinically N0 (cN0) neck in patients with oral squamous cell carcinoma (OSCC).

Methods

Histologic and follow-up data of 87 patients with previously untreated OSCC undergoing I–IV SND and 41 undergoing I–III SND between 2002 and 2006 were reviewed.

Results

Of the 98 I–IV SNDs performed, 4 had involvement of level IV. No relationship between tumor variables and level IV involvement was identified. Survival analysis failed to demonstrate a significant difference between I–III and I–IV SND in terms of developing neck recurrence in the 2 years following surgery.

Conclusions

Level I–III SND is effective management of the cN0 neck (when coupled with postoperative radiotherapy in selected cases) in patients with OSCC, although it is recommended that a larger prospective study be performed in this field. © 2010 Wiley Periodicals, Inc. Head Neck, 2010

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