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Category: Volume 08 Issue 12 December 2020
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Title: Role of elective neck dissection in the management of early oral tongue carcinoma

Authors: Mohammad Amzad Hossain, AHM Parvez Humayun, Mostofa Kamal Masud, Muhammad Bipul Islam, Mohammad Anamul Haq, SM Abdul Awual

 DOI: https://dx.doi.org/10.18535/jmscr/v8i12.25

Abstract

Objective: To evaluate the efficacy of elective neck dissection as a therapeutic and as well as diagnostic procedure for early oral tongue cancer patients with No neck.

Methods: This observational/retrospective study was carried out during the period of July 2012 to December 2014, among the patients, admitted in the Department of ENT Oncology of National Institute of Cancer Research & Hospital, Mohakhali, Dhaka. For this 30 patients of early oral tongue cancer (T1 & T2) of all age & sex, which were with clinically No neck, were included in this study. Detailed history taking, thorough clinical examination of oral cavity, neck and preoperative punch biopsy from tongue lesion was done in every case. Wide local excision or hemiglossectomy with proper margin clearance in all cases and elective neck dissection was done in selective cases. Histopathological examination of excised primary tongue lesion & neck nodes was also done in each & every cases.

Results: There were 30 patients in this study, including 14(46.66%) withT1 and 16(53.33%) with T2 oral tongue carcinoma. The first site of tumour recurrence was regional that is 6 (20%), both regional & local were 1(3.33%) and local recurrence was 2(6.66%). Among the 30 No neck patients, who had done neck dissection (18 patients), regional recurrence was seen in 2 cases (11.11%) and patients who were under observation(12 patients) recurrence was seen in 5 cases that is 41.66%. The result of our study has been tested by two sample Z test and has found that recurrence is significantly high in patients who were in observation. At the same time occult node positive disease was found interestingly in 33.33% cases. So elective neck dissection has also the advantage of more accurate pathological diagnosis or staging of neck.

Conclusion: Elective neck dissection significantly reduces the regional recurrence in case of management of early oral tongue cancer. At the same time it is a very important diagnostic tool.

Keywords: Occult node positive disease, oral tongue cancer.

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Corresponding Author

Mohammad Amzad Hossain

Associate Professor & Head, Department of ENT & Head-Neck Surgery, Shaheed Tajuddin Ahmad Medical College, Gazipur, Bangladesh