Discontinuous partial glossectomy and radical neck dissection in selected patients with epidermoid carcinoma of the mobile tongue

Abstract

Radical neck dissection is often indicated in patients who have epidermoid carcinoma arising in the oral cavity. Inasmuch as viable tumor cells may be present in the lymphatics between the primary and involved regional nodes, the neck operation is usually performed in continuity with excision of the primary tumor. If a cheek flap must be elevated and a segment of mandible removed to secure an adequate margin, en bloc resection of the ipsilaterat neck contents poses no problem. Conversely, neck dissection in continuity is usually not feasible in those who have anteriorly placed lesions in the palate, upper gingiva, or tongue. In some instances the effort to preserve continuity may complicate the operation and even lead to unnecessary sacrifice of normal tissue. It has been our impression that the principle of in continuity neck dissection may be abandoned in certain patients without affecting the cure rate. Data relevant to this question are available from a recent study of Memorial Hospital patients treated for epidermoid carcinoma of the tongue [•]. A few patients with lesions suitable for local excision through the open mouth also had discontinuous radical neck dissection. This group will be corhpared with those who had partial glossectomy alone and those with larger or more inaccessible tumors who required radical, in continuity operation (commando).