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Is neck dissection necessary in early stage lower lip carcinomas necessary?

Orhan Kemal Kahveci, Cigdem Tokyol, Yavuz Demir, Erdogan Okur, Selcuk Kuzu, Abdullah Aycicek, Nurten Haktanir.

Lower lip tumours are the most common among the oral cavity tumours. The purpose of this article is to analyse neck metastasis rates of early stage lower lip carcinomas and to evaluate possible related histological parameters with neck metastasis. The dissection types, preoperative detection of lymphadenopathy by palpation or computed tomography (CT), tumour sizes and tumour histological differentiation degrees of 37 patients were reviewed retrospectively. In addition, an experienced pathologist re-evaluated the specimens and examined tumour depth and muscle invasion. Types of neck dissection were bilateral supraomohyoid in 20, unilateral supraomohyoid in 8, bilateral suprahyoid in 5 and unilateral suprahyoid in 1 patients. All the carcinomas were squamous cell carcinoma (SCC) and T stages were T1 in 32 and T2 in 5. Preoperatively, 4 patients had palpable lymph nodes and 9 patients had lymph nodes in CT scan, but it was found out that none of these patients had histological positive lymph node metastasis. Histological node metastasis was found only in 1 patient who had stage T1 tumour, no palpable or detected lymph node, no muscular invasion and very limited tumour depth.Tumour size, differentiation degree, tumour depth and muscle invasion seems insensitive for predicting lymph node metastasis in early stage lower lip carcinomas. The necessity of neck dissection in early stage lower lip carcinomas should be reconsidered in large series of patients.

Key words: Lower lip carcinoma, neck dissection, squamous carcinoma, lymph node metastasis

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