Neck failure after elective neck dissection in patients with oral squamous cell carcinoma.

OBJECTIVE: Analysis of the incidence and clinical relevance of neck failure after elective neck dissection (END) in patients with oral squamous cell carcinoma (OSCC).

STUDY DESIGN: A retrospective study of 188 patients with OSCC without cervical lymph node metastases was conducted; these patients had undergone END from 2005 to 2015. The most common primary tumor location was lower gingiva, followed by tongue.

RESULTS: Supraomohyoid neck dissection (SOHND) was the most common procedure. Neck failure developed in 4 pathologic negative (pN[-]) and 3 pathologic positive (pN[+]) patients. The site of neck recurrence was beyond the dissected field in all cases. The site of recurrence in pN(-) patients was ipsilateral in 2 patients and contralateral in 2, whereas the site in pN(+) patients was ipsilateral in 1 patient and contralateral in 2.

CONCLUSIONS: Although neck failure after END can occur, SOHND is appropriate for END for OSCC. For tongue carcinoma, level IV dissection is recommended, and for tumors close to the midline, contralateral neck dissection is also recommended.