Jakhetiya Ashish, Kaul Pallvi, Pandey Arun, Patel Tarang, Kumar Meena Jitendra, Pal Singh Mahendra, Kumar Garg Pankaj
Department of Surgical Oncology, Geetanjali Medical College and Hospital, Udaipur, India.
Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, India.
Oral Oncol. 2021 Jul;118:105316. doi: 10.1016/j.oraloncology.2021.105316. Epub 2021 Apr 30.
Though the submandibular gland (SMG) is routinely sacrificed for several reasons during neck dissection in patients undergoing curative surgery for oral cavity cancers, it might be an innocent bystander and should be considered for preservation. This study aimed to identify the incidence, different patterns of invasion, and risk factors of SMG involvement in oral cavity squamous cell carcinoma (SCC).
This was a retrospective study of the patients who underwent upfront curative surgery for a biopsy-proven oral cavity SCC. A consistent protocol-based treatment strategy was followed during the study period. Data about clinical profile including demographics, clinical and histology details, and treatment profile were extracted and analysed.
A total of 303 patients underwent unilateral and bilateral neck dissections contributing 79.2% (n = 240) and 20.8% (n = 63) of patients respectively. The common primary sites were buccal mucosa (n = 129, 42.5%), tongue (n = 100, 33.0%) and alveolar gingiva (n = 52, 17.2%). A total of four SMGs showed tumor involvement resulting in a prevalence of 1.09% per neck dissection (n = 366) and 1.32% per patient (n = 303). Of these four cases of SMG involvement, one patient with alveolar cancer had direct tumor invasion while the other three (alveolar cancer - two, tongue cancer - one) patients had neck node metastasis.
The present study confirms a very low incidence of SMG involvement in patients with oral cavity cancer who undergo neck dissection. It is often observed in patients with high neck node burden (≥N2 disease and the presence of extracapsular spread) or direct invasion by the primary tumor.
尽管在口腔癌根治性手术患者的颈部清扫术中，由于多种原因通常会切除下颌下腺（SMG），但它可能是无辜的旁观者，应考虑予以保留。本研究旨在确定口腔鳞状细胞癌（SCC）中SMG受累的发生率、不同的浸润模式及危险因素。
这是一项对经活检证实为口腔SCC并接受 upfront 根治性手术患者的回顾性研究。在研究期间遵循基于一致方案的治疗策略。提取并分析了包括人口统计学、临床和组织学细节以及治疗情况等临床资料数据。
共有303例患者接受了单侧和双侧颈部清扫，分别占患者总数的79.2%（n = 240）和20.8%（n = 63）。常见的原发部位为颊黏膜（n = 129，42.5%）、舌（n = 100，33.0%）和牙槽龈（n = 52，17.2%）。共有4个SMG显示有肿瘤累及，导致每例颈部清扫（n = 366）的患病率为1.09%，每例患者（n = 303）的患病率为1.32%。在这4例SMG受累病例中，1例牙槽癌患者有肿瘤直接浸润，而其他3例（牙槽癌2例、舌癌1例）患者有颈部淋巴结转移。
本研究证实，接受颈部清扫的口腔癌患者中SMG受累的发生率非常低。在颈部淋巴结负荷高（≥N2期疾病且有包膜外扩散）或原发肿瘤直接浸润的患者中经常观察到这种情况。
