Ipsilateral Radical Neck Dissection Research Articles

Surgical treatment of pyriform fossa cancer

The present prospective study evaluates the results of therapy in pyriform fossa cancer patiens. Primary radical surgery including ipsilateral radical neck dissection gave distinctly superior results than the radiation-failed-salvage surgery group (63% varsus 30%). The poor results in the latter group may be attributed to the delay in performing surgery, resulting in larger size of primary lesions and the fact that radiotherapy may impair our ability to determine adequate resected margins. We new favour a protocol consisting of primary radical surgery followed in a planned manner by postoperative radiotherapy in treating these cancers.

下いん頭・けい部食道がん治療の進歩 進展病理と転移からながめた手術法

The treatment results of 166 patients with hypopharyngeal and cervical esophageal cancers were analyzed. They were 18 cases of Stage I, 35 Stage II, 56 Stage III, and 39 Stage IV, and treated by surgery or radiotherapy.Among all these cases, 75 cases were treated surgically, and the accumulated survival rate was 30%.The points requiring our highest attention for the operation were how long safety margin is required for complete resection of the primary lesion and what radial neck dissection should be adopted.In spite of two to three cm of the upper and lower surgical safety margins, recurrence was noted in the mesopharynx in seven cases. Elective irradiation may, thus, be reasonable to those cases where recurrence in the mesopharynx is anticipated.For pyriform sinus cancer, ipsilateral radical neck dissection must always be made simultaneously.For other cancers originating from the postcricoid, posterior wall and cervical esophagus, bilateral neck dissection may be indicated. Thyroidectomy with paratracheal node dissection may be indispensable for postcricoid and cervical esophageal cancers.

Surgical treatment of cervical lymph nodes in carcinoma of the tongue.

A series of 56 cases of carcinoma of the anterior two-thirds of the tongue treated surgically was reviewed. Lymph node metastasis occurred in 50% of cases. There was 22% false-negative clinical assessments of lymph node status for the ipsilateral side of the neck. Because of these and the difficulty in ensuring early treatment of subsequent node metastasis, concurrent ipsilateral radical neck dissection is recommended. When the ipsilateral side of the neck was involved the contralateral side has 22% false-negative assessments. Elective radical neck dissection for the contralateral side is recommended in this situation. The overall five-year survival was 50.6%, and was greatly affected by the status of the neck lymph nodes.

Branchiogenic carcinoma — fact or fallacy?

The ongoing debate concerning the existence of malignant transformation of branchial cleft cysts has been analyzed, with the aid of previous reports and reviews in the literature. Six new cases are presented and illustrated. These occurred in 4 male and 2 female patients, having an average age of 60 years. Two of the lesions were within the parotid salivary gland. The longest period of survival was 3 1/2 years. New criteria for the acceptability of tumors as primary branchiogenic cancers are proposed. We believe that, using these strict criteria, rare examples of primary branchiogenic carcinomas do exist; their treatment should include whide local excision, followed by ipsilateral radical neck dissection.