En Block Versus Separate Management of Cervical Nodes in Tongue and Floor of the Mouth Cancers- Is There a Difference? An Analysis of 85 Cases in a Tertiary Care Institute

AbstractTo evaluate difference in local recurrence, regional (neck) recurrence as well as distant metastases between cases operated with en-block excision of primary cancer and neck nodes versus their separate removal, in squamous cell carcinomas of anterior 2/3 of tongue and floor of the mouth. A total 85 patients of cT1-T4a N0-N2b of carcinoma  anterior 2/3 of tongue and floor of mouth were evaluated. Amongst these patients 39 cases of in-continuity en-block neck dissection and 46 cases of discontinuous neck dissection were evaluated for post-operative complications as well as oncological outcome for a follow up period of 3 years. P atient population was similar in both groups with tongue cancers being the commonest site and tobacco being the most common addiction. Primary site hematoma was seen more in the in-continuity en-block neck dissection group with ap-value of 0.0276, which was statistically significant. Post-operative oro-cutaneous fistula occurred more in in-continuity  enblock neck dissection as compared to discontinuous neck dissection, but the difference was not statistically significant. Local recurrence rate was significantly more in cases of discontinuous neck dissection (19.565) as compared to in-continuity en-block neck dissection (5.12%) with ap-Value 0.0481. A statistically non-significant but higher loco-regional recurrence was observed in cases of discontinuous neck dissection as compared to cases of  in-continuity en-block neck dissection (...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research