ISSN 2149-3987 | E-ISSN 2149-553X
Original Article
Distribution of Metastatic Nodes in N0-1 Patients with Tonsillar Squamous Cell Carcinoma and Its Implications for Selective Neck Dissection
1 Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Center, São Paulo, Brazil  
2 Department of Pathology, A. C. Camargo Cancer Center, São Paulo, Brazil  
3 Department of Research and Development, A. C. Camargo Cancer Center, São Paulo, Brazil  
Turk Arch Otorhinolaryngol 2018; 56: 139-144
DOI: 10.5152/tao.2018.3420
Key Words: Oropharyngeal neoplasms, palatine tonsil, squamous cell carcinoma, metastasis, neck dissection
Abstract

 

Objective: We aimed to evaluate the pattern of neck metastasis in patients with primary tonsillar carcinoma treated by primary surgery and neck dissection. Impact of the extent of neck dissection and level of metastatic nodes on survival were also evaluated.

 

Methods: We evaluated 163 consecutive patients with tonsillar squamous cell carcinoma submitted for neck dissection and staged as cN0-1. Selective neck dissection was performed using a template encompassing levels I-III, whereas radical neck dissection led to the removal at levels I-V. For each patient, number of metastatic nodes, their distribution, and data regarding postoperative treatment and oncologic outcomes were analyzed.

 

Results: Occult neck metastasis at levels I, IV, and V were rare with two cases each. In the clinically negative (cN0) patients, there were no cases of metastasis at level V and two cases at level I or IV. The extent of neck dissection and level of metastatic nodes had no impact on disease-specific survival or neck recurrence.

 

Conclusion: We conclude that in cN0 patients, removal at levels II and III is mandatory but levels I, IV, and V may be spared.

 

Cite this article as: Köhler HF, Franzi SA, Soares FA, Torloni H, Kowalski LP. Distribution of Metastatic Nodes in N0-1 Patients with Tonsillar Squamous Cell Carcinoma and Its Implications for Selective Neck Dissection. Turk Arch Otorhinolaryngol 2018; 56(3): 139-44.

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