The incidence of Sublevel IIb Lymph Nodes Metastasis in Oral Cavity Squamous Cell Carcinoma: A Prospective Study

Document Type : Original Article

Authors

1 Lecturer of Oral and Maxillofacial surgery, Faculty of dentistry - Cairo University

2 Professor of Surgical Oncology-National Cancer Institute - Cairo University.

Abstract

Purpose: Lymph node metastasis has an important influence on patient survival after oral cancer. This study aimed to evaluate the incidence of metastasis to Sublevel IIb lymph nodes in patients with squamous cell carcinoma of the oral cavity.
Materials and methods: Thirty patients with Oral Cavity Squamous Cell Carcinoma (SCC) were included in this study. They were selected from the out-patient clinic in the National Cancer Institute, Cairo University. All cases were subjected to surgical resection of the primary site with safety margin according to the standard protocol for each specific site. Functional neck dissection (ND) for neck lymph nodes and dissection for sublevel IIb lymph nodes were preformed separately. Histopathological examination of the specimens of the primary tumor sites, the neck lymph nodes and the level IIb lymph nodes was performed separately.
Results: In all thirty neck dissections, examination of the level IIb provided a negative result, except in only one case (3.3%). This case was SCC of the tongue. The metastasis at sublevel IIb in this case was observed without metastasis at levels IIa, III or IV. Neck Lymph node metastasis was found in 53.3% of the patients who underwent therapeutic neck dissection for oral SCC.
Conclusions: Based on our study we concluded that metastatic spread of oral cavity SCC to level IIb in cases of clinically positive neck (cN+) is rare.

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