SUPRAOMOHYOID NECK DISSECTION AS A STAGING PROCEDURE FOR SQUAMOUS-CELL CARCINOMAS OF THE ORAL CAVITY AND OROPHARYNX

Background. A multi-institutional retrospective study was performed to evaluate the efficacy of the supraomohyoid neck dissection (SOHND) for detection of occult cervical metastasis in squamous cell carcinoma of the oral cavity and oropharynx. Methods. Seventy-five previously untreated patients with clinically negative necks were studied. Seventeen (23%) neck specimens revealed occult metastatic disease, and 58 (77%) were histologically negative. Postoperative irradiation was received by 94% of the patients with positive specimens and 22% with negative specimens. Patients were followed until recurrence of neck disease, or for a period of 2 years or longer. Results. Cervical metastasis subsequently developed in 25% of treated positive specimen patients, none of the untreated positive specimen patients, 8% of the treated negative specimen patients, and 11% of the untreated negative specimen patients. The sensitivity of SOHND for cervical metastasis was 82%, negative predictive value 91%, and accuracy 94%. Conclusions. The authors conclude that SOHND is a useful procedure for detection of occult cervical metastatic disease in cancer of the oral cavity and oropharynx. (C) 1995 John Wiley and Sons, Inc.