下顎歯肉癌の頸部転移様相と部分的郭清術の評価

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Among 41 primary patients with squamous cell carcinoma of the lower gum treated at our Department of Oral Surgery between 1961 and 1980, 21 patients received neck dissection because of possible cervical lymph node metastasis. In these patients, mode of the cervical lymph node metastasis was examined and the application of partial neck dissection was evaluated.<BR>Metastasis to the lymph nodes had histological confirmation in 11 patients. However the metastasis were all confined to the upper neck region (submental, submandibular and superior internal jugular nodes) but the contralateral submandibular lymph nodes were also involved in 3 cases. Primary lesions of these 3 cases were located in the anterior part of the lower gum.<BR>Partial neck dissection was performed on 12 patients and 6 had histologically positive lymph nodes. Two of them had recurrence in superior internal jugular region, although the primary lesions were under control. In these cases there were many large metastatic lymph nodes that firmly adhered to the surrounding tissuese. Subsequent secondary radical neck dissection was difficult.<BR>It was concluded from these findings that the radical neck dissection is be indicated for lower gum cancer when clinical signs of neck metastasis are noticed. When partial neck dissection is indicated for unavoidable reasons, it is necessary to thoroughly dissect the supraomohyoid region.
社団法人日本口腔外科学会の論文