[Effectiveness of neck dissection in metastasizing mouth carcinoma. Uni- and multivariate analysis of factors of influence].

BACKGROUND

The purpose of this study was to evaluate the oncologic effectiveness of radical and different types of modified neck dissections with preservation of n. accessorius, v. jugularis interna, and m. sternocleidomastoideus and to identify prognostic factors for regional control and survival in univariate and multivariate analysis.

METHODS

This retrospective study included 373 patients with squamous cell carcinoma of the oral cavity who underwent 401 neck dissections between January 1986 and December 1995 at the Department for Oral and Maxillofacial Surgery, Hanover Medical School.

RESULTS

The 5-year regional control was estimated at 87%. Relapse occurred only within the first 2 years after neck dissection. The number of positive nodes, metastases without lymphatic tissue, preparation of metastases from the carotid artery and cranial base, and preoperative radiochemotherapy were analyzed as prognostic factors with significant influence. The grade of metastases, extracapsular spread, lymphangiosis carcinomatosa, and postoperative radiation showed no prognostic significance.

DISCUSSION

The comparison of recurrent metastases after radical and modified neck dissection demonstrated that as the extent of neck disease increased there was a tendency toward improved regional control after radical neck dissection.