Micrometastasis and Recurrent Neck Node in Supraomohyoid Neck Dissection field
Somjin Chindavijak, MD*
Affiliation : * Otolaryngology Division, National Cancer Institute Thailand
Objectives : Supraomohyoid neck dissection (SOHND) is one of the treatment for clinically negative neck
disease in carcinoma of the oral cavity when primary is treated with surgery. Neck tumor recurrence in these
patients who were treated by SOHND with and without post-operative radiotherapy was evaluated.
Materials and Methods : Forty-four patients with squamous cell carcinoma of the oral cavity aged between 33-
78 years was studied. Every case had clinically negative neck and was treated with SOHND.
Results : There were 53 supraomohyoid neck dissections. The overall recurrence rate was 11.3% (6/53). The
duration of recurrence ranged from six to nine months and was seen in five of pathologically negative neck
and one in pathologically positive neck. Five of six of the recurrence cases were in the field of SOHND without
post-operative radiotherapy. Histopathological review with immunohistochemistry study of all recurrent
cases that was previously reported as negative by H&E stain showed no micrometastasis. The 5-yr survival of
neck node metastasis was 64% versus 82% of these with no lymph node metastasis which showed no statisti-
cally significant difference.
Conclusion : The SOHND was useful for treating clinical negative neck of oral cancer with high percentage of
occult lymph node. The pathological report influenced the adjuvant treatment. Micrometastasis and other
indicators for this pathologically negative neck is still await further study to improve survival of this particu-
lar group of patients.
Keywords : Micrometastasis, Recurrent, Supraomohyoid neck dissection
