Chapters authored
The Role of Neck Dissection in Oral Cavity Carcinoma
Nodal status at the time of presentation for oral cavity carcinoma is the most important prognostic factor. Neck dissection is warranted for T3/T4 oral cavity carcinoma but there has been an ongoing controversy in the treatment of clinically negative neck in T1/T2. The risk of occult metastases in N0 squamous cell carcinoma of the oral cavity is 20–30%, and was found highest for tongue carcinoma. Elective neck dissection is recommended for T2N0 tongue carcinoma, and Stage I clinically N0 oral cavity carcinoma with tumor thickness >3 mm. CT scan has the highest sensitivity in detecting occult cervical lymph node metastases. Sentinel lymph node biopsy, as well as identification of biomarkers, continue to show increased utility. This chapter aims to discuss the methods of detecting nodal metastasis, the need for elective neck dissection for clinically neck node negative T1/T2 oral cavity carcinoma, the role of watchful waiting in N0 necks, the impact of tumor thickness in the risk for cervical lymph node metastasis, the role of sentinel lymph node biopsy in the detection of occult lymph node metastasis, and the role of biomarkers as predictors of occult lymph node metastasis.
Part of the book: Oral Diseases