engleski

Oral cavity cancer: is retropharyngeal dissection indicated?

The dissection of retropharyngeal lymph nodes (RPN) does not seem to be a routine part of head and neck tumor resection and is not reported as a part of surgical treatment of oral cancer. The purpose of this report is to examine the incidence of metastases to the retropharyngeal lymph nodes and the value of retropharyngeal lymph node dissection in patients with squamous carcinoma of the oral cavity. In the period 1980-2005 238 patients had a retropharyngeal dissection as an extension of neck dissection including 121 patients with oral cancer. All RPN dissections were elective. Lymph nodes were found to be present in 110 retropharyngeal specimens and a metastasis to the RPN was found in 21 patients (19%). All patients with metastasis to the RPN had pathologically positive nodes elsewhere in the ipsilateral neck. The disease specific 5-year survival rate for oral cancer patients with positive RPN was 24%, for negative RPN 54%. Metastases to the RPN are present also in patients with oral cancer and their dissection should be considered in the treatment plan, especially for patients with a clinically positive neck. Since retropharyngeal lymph nodes are not within the efferent lymphatic pathways of the oral cavity retrograde spread to this lymph node group may be assumed. The retropharyngeal nodes are difficult to assess preoperatively but easy to dissect during a composite resection. The surgical technique will be described in detail.

oral cavity cancer; retropharyngeal lymph nodes; metastases

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