Topics:
Head and Neck Cancers • Radiation Oncology
Does a negative neck dissection adequately cover the treatment of the neck for a patient that clearly needs PORT for an oral tongue cancer?
In a patient with a pT1-2 oral tongue cancer resected with negative margins and with a fully negative ipsilateral neck dissection, but with indications for post-op RT to the tumor bed(+LVI/PNI), do you feel comfortable omitting radiotherapy to the neck?
Answer from: Radiation Oncologist at Academic Institution
I do not feel comfortable omitting RT to the neck in cases of oral tongue cancer. The lymphatic drainage of the oral tongue is complex. The textbook on Head and Neck cancer by Million and Cassisi (2nd ed., Figure 16-31) has a nice representation of the crossing lymphatics of the oral tongue. From th...
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Answer from: Radiation Oncologist at Community Practice
I agree with @Farzan Siddiqui that the lymphatic drainage of the oral tongue is complex and warrants aggressive treatment, but the statistics he quotes from the recent NEJM article are not quite as dire as stated. When examining table 2, one notes there were 25 nodal recurrences in the elective...