O-015. the role of supraomohyoid neck dissection in patients with oral cavity carcinomas

Aims: To assess the potential role of supraomohyoid neck dissection (SOHND) as a therapeutic procedure in patients with oral cavity carcinomas. Methods: From July 1993 to June 1998, 140 patients with oral carcinomas and clinically negative lymph nodes in the neck underwent elective SOHND. Thirty-seven patients further had postoperative radiotherapy. Unilateral SOHND was performed in 114 patients, while bilateral SOHND was performed in 26 patients with floor of mouth carcinomas. Two-year follow-up information was available on all patients. Results: There were 34 (24.3%) patients with occult cervical metastases. There were 12 (8.6%) cases of neck recurrences, including one in the contralateral neck, and 11 within the neck dissection margins. To date, only one of these 12 patients was alive, while the other 11 patients died of diseases. The overall regional control rates were 93.4 vs. 85.3% for pathologically negative vs. positive nodes, respectively, with or without adjuvant radiotherapy. Adjuvant radiotherapy significantly improved regional control (P = 0.047) in patients with occult cervical metastases but not in patients with negative neck disease. Conclusion: Supra-omohyoid neck dissection can be a therapeutic procedure for clinically negative necks. However, in patients with pathologically positive nodes in the neck, postoperative radiotherapy significantly improved regional control rate.