Clinical study of neak failure after radical neck dissection in head and neck squamous cell carcinoma.

  • Matsunaga Kazuhide
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • Yoshikawa Hiromasa
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • Nagata Tetsuji
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • Oobu Kazunari
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • Shima Kaori
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • Sasaguri Masaaki
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • Ohishi Masamichi
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University

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Other Title
  • 口腔癌における頚部郭清術後の頚部転移死症例の検討

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Abstract

The cases that died of neck failure, among 271 patients with squamous cell carcinoma of the head and neck who underwent radical neck dissection between 1985 and 1999, were studied with respect to the primary site, operation method, period until nodal recurrence, region of nodal recurrence, and mode of metastasis.<BR>The results were as follows:<BR>1) Of 271 patients, 173 cases were found to have pathologically positive neck lymph nodes, and 13 cases died of neck failure.<BR>2) Primary sites in these 13 patients were the tongue in 9 cases, the lower gum in 3 cases, and the mouth floor in 1 case.<BR>The average period until nodal recurrence was 5.3 months, and the nodal recurrence in 12 cases occurred within 1 year after radical neck dissection.<BR>3) Extracapsular spread was seen in 11 cases (84.6%), in which 11 neck sides (78.6%) were affected out of 14 sides.<BR>The average diameter of the longest metastatic lymph node of each case was 33.4 mm. Even in the 3 neck sides without extracapsular spread, there were multiple metastases, with an average number of 14 metastatic lymph nodes, ranging in 3 to 6 regions.<BR>4) Nodal recurrence was seen in the area of radical neck dissection in all cases, and in the site of extracapsular spread or of primary metastatic lymph nodes.<BR>From these results, it was suggested that the prognosis of patients with multiple metastasis in more than three regions or extracapsular spread is poor.

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