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Perifacial lymph node metastasis in the submandibular triangle of patients with oral and oropharyngeal squamous cell carcinoma with clinically node-positive neck.
Laryngoscope 2006; 116(12):2187-90L

Abstract

OBJECTIVES

The objectives of this retrospective chart review were to investigate the rate of metastasis to the perifacial lymph node, which was defined as the nodal pads that lie anterior or posterior to the anterior facial vein on top of the facial artery in the submandibular triangle, and to identify its risk factors in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC) with clinically node-positive neck.

METHODS

Beginning in July 1999, we routinely removed the perifacial lymph node pads of the submandibular triangle (level Ib) from the main therapeutic comprehensive neck dissection (level I-V) specimen for evaluation of metastatic rate to this nodal group in patients with OOSCC with clinically node-positive neck. This study is a retrospective analysis of patients undergoing perifacial node sampling from July 1999 to March 2006. A total of 66 patients (17 patients with oral cavity cancer and 49 with oropharyngeal cancer) underwent perifacial lymph node dissections. Of these, three (two with oral cavity tumors and one with an oropharynx tumor) had clinically positive node in level I.

RESULTS

The incidence rate of metastasis to the perifacial lymph node was 35% in oral cavity carcinoma (six of 17) and 8% in oropharynx carcinoma (four of 49). In addition, in patients without clinically positive level I node, the occult metastasis rate of the perifacial node was 27% in oral cavity carcinoma (four of 15) and 6% in oropharynx carcinoma (three of 48). Clinical or pathologic nodal staging above the N2b advanced lesion had a statistically significant association with perifacial lymph node metastasis (P < .05).

CONCLUSION

Our data suggest that these nodal pads should be removed thoroughly for the treatment of node-positive neck in patients with oral cavity carcinoma. In contrast, however, complete removal may be unnecessary in comprehensive neck dissection of patients with oropharyngeal carcinoma with clinically node-positive neck, especially below nodal stage N2a.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17146394

Citation

Lim, Young Chang, et al. "Perifacial Lymph Node Metastasis in the Submandibular Triangle of Patients With Oral and Oropharyngeal Squamous Cell Carcinoma With Clinically Node-positive Neck." The Laryngoscope, vol. 116, no. 12, 2006, pp. 2187-90.
Lim YC, Lee JS, Choi EC. Perifacial lymph node metastasis in the submandibular triangle of patients with oral and oropharyngeal squamous cell carcinoma with clinically node-positive neck. Laryngoscope. 2006;116(12):2187-90.
Lim, Y. C., Lee, J. S., & Choi, E. C. (2006). Perifacial lymph node metastasis in the submandibular triangle of patients with oral and oropharyngeal squamous cell carcinoma with clinically node-positive neck. The Laryngoscope, 116(12), pp. 2187-90.
Lim YC, Lee JS, Choi EC. Perifacial Lymph Node Metastasis in the Submandibular Triangle of Patients With Oral and Oropharyngeal Squamous Cell Carcinoma With Clinically Node-positive Neck. Laryngoscope. 2006;116(12):2187-90. PubMed PMID: 17146394.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perifacial lymph node metastasis in the submandibular triangle of patients with oral and oropharyngeal squamous cell carcinoma with clinically node-positive neck. AU - Lim,Young Chang, AU - Lee,Jin Seok, AU - Choi,Eun Chang, PY - 2006/12/6/pubmed PY - 2007/1/11/medline PY - 2006/12/6/entrez SP - 2187 EP - 90 JF - The Laryngoscope JO - Laryngoscope VL - 116 IS - 12 N2 - OBJECTIVES: The objectives of this retrospective chart review were to investigate the rate of metastasis to the perifacial lymph node, which was defined as the nodal pads that lie anterior or posterior to the anterior facial vein on top of the facial artery in the submandibular triangle, and to identify its risk factors in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC) with clinically node-positive neck. METHODS: Beginning in July 1999, we routinely removed the perifacial lymph node pads of the submandibular triangle (level Ib) from the main therapeutic comprehensive neck dissection (level I-V) specimen for evaluation of metastatic rate to this nodal group in patients with OOSCC with clinically node-positive neck. This study is a retrospective analysis of patients undergoing perifacial node sampling from July 1999 to March 2006. A total of 66 patients (17 patients with oral cavity cancer and 49 with oropharyngeal cancer) underwent perifacial lymph node dissections. Of these, three (two with oral cavity tumors and one with an oropharynx tumor) had clinically positive node in level I. RESULTS: The incidence rate of metastasis to the perifacial lymph node was 35% in oral cavity carcinoma (six of 17) and 8% in oropharynx carcinoma (four of 49). In addition, in patients without clinically positive level I node, the occult metastasis rate of the perifacial node was 27% in oral cavity carcinoma (four of 15) and 6% in oropharynx carcinoma (three of 48). Clinical or pathologic nodal staging above the N2b advanced lesion had a statistically significant association with perifacial lymph node metastasis (P < .05). CONCLUSION: Our data suggest that these nodal pads should be removed thoroughly for the treatment of node-positive neck in patients with oral cavity carcinoma. In contrast, however, complete removal may be unnecessary in comprehensive neck dissection of patients with oropharyngeal carcinoma with clinically node-positive neck, especially below nodal stage N2a. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/17146394/Perifacial_lymph_node_metastasis_in_the_submandibular_triangle_of_patients_with_oral_and_oropharyngeal_squamous_cell_carcinoma_with_clinically_node_positive_neck_ L2 - https://doi.org/10.1097/01.mlg.0000244390.40200.e1 DB - PRIME DP - Unbound Medicine ER -