Lymphatic Mapping to Tailor Selective Lymphadenectomy in Squamous Cell Carcinoma of Oral Cavity

Abstract

Objective: The purpose of this study was to determine the distribution of cervical lymph node metastases in the Squamous cell carcinoma of oral tongue and or floor of mouth; hence to improve the pretreatment evaluation of these patients. Study design: Descriptive study. Setting: Department of Oral and Maxillofacial Surgery, King Edward Medical University/ Mayo Hospital Lahore. From 1st July 2008 to 31st December 2009. Methods: This study was carried out on 50 consecutive patients who were having Squamous cell carcinoma of oral tongue and or floor of the mouth with T1 – T4 lesions. Results: Neck lymph node levels I and II were the most common sites of cervical lymph node metastases that was, 30%. Levels IV and V were involved very rarely. The overall metastases to cervical lymph node levels I – III combined was seen in 90% cases of oral tongue or floor of the mouth. Conclusion: The most common region for cervical lymph node metastases in Squamous Cell Carcinoma of oral tongue and floor of mouth is levels I – III in the ipsilateral neck, so based on pattern of metastases, supraomohyoid neck dissection for cN0 and functional neck dissection for cN+ necks are suggested. Key Words: Oral Squamous cell carcinoma (OSCC), cervical lymph node metastasis, cN0 (clinically lymph node negative), cN+ (clinically lymph node positive) (N1 – N3), pN+ (pathologically lymph node metastases found), elective neck dissection, occult metastasis, radical neck dissection (RND).