EXTENT OF LYMPH-NODE DISSECTION IN T3 T4 CANCER OF THE ALVEOLO-BUCCALCOMPLEX/

Background. Cancer of the alveolo-buccal complex even when locally adv anced is amenable to curative resection. However, the extent of lymph node dissection remains controversial. Methods. A total of 181 patient s with T3/T4 cancer of the alveolo-buccal complex who underwent a radi cal neck dissection (RND) were analyzed retrospectively to determine t he incidence and pattern of lymph node involvement and to define the e xtent of neck dissection required in these cancers. Results. Lymph nod e involvement was as follows: level I (85%), II (51%), III (19%), IV ( 18%), V (5%). Levels I and II were most commonly involved (94%). Skip metastases occurred in 13%. Levels IV and V were involved in 2% and 20 % when levels I, II, and III were uninvolved and involved, respectivel y. Conclusion. A supraomohyoid neck dissection (SOHD) should be perfor med and subjected to a frozen section evaluation in every patient. If lymph nodes are negative, then SOHD is adequate. If levels I, II, or I II are positive, then a RND should be performed. (C) 1995 John Wiley a nd Sons, Inc.