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Vol. 70. Issue 2.
Pages 68-73 (March - April 2019)
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Vol. 70. Issue 2.
Pages 68-73 (March - April 2019)
Original article
Behavior of squamous cell carcinoma of the floor of the mouth. Is supraomohyoid neck dissection sufficiently safe to manage clinically N0 patients?
Carcinoma epidermoide del suelo de la boca. ¿Es suficientemente seguro el vaciamiento cervical supraomohioideo para tratar clínicamente a los pacientes N0?
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Paolo Cariati
Corresponding author
paolocariati1@gmail.com

Corresponding author.
, Almudena Cabello Serrano, Maria Roman Ramos, Dario Sanchez Lopez, Jose Fernandez Solis, Ildefonso Martinez Lara
Hospital Virgen de las Nieves, Granada, Spain
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Table 1. histological features related to the presence of lymph node metastasis.
Table 2. Outcome in relation to histological features.
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Abstract
Aim

The main aim of the present report is to study the behavior of SCC of the floor of the mouth.

Materials and method

A retrospective analysis was conducted using the records of patients diagnosed with squamous cell carcinoma of the floor of the mouth between 2000 and 2012 in the HUVN. Ninety-three patients with squamous cell carcinoma of the floor of the mouth treated with tumourectomy and selective neck dissection were included in the study. The pattern of distribution of cervical metastases and numerous histological features such as T-stage, N stage, surgical margins, tumor thickness, ECS (extracapsular spread) and vascular invasion were analyzed.

Results

Level I was the most affected level, followed by Level II. T stage, tumor thickness, and surgical margins showed a strong relationship with the risk of developing a local or cervical failure at follow-up. Overall survival was 52.7%. T stage, tumor thickness, N stage, recurrence, extracapsular spread, and vascular invasion were also associated with a poor prognosis.

Conclusions

SCC of the floor of the mouth is an aggressive disease even at early stages. Due to the low rate of positive nodes observed at level IV and V in clinically N0 patients, supraomohyoid neck dissection might be considered sufficiently safe in this group.

Keywords:
Floor of the mouth
Oral squamous cell carcinoma
Aggressive behavior
Supraomohyoid neck dissection
Resumen
Objetivo

El principal objetivo de este estudio es estudiar el comportamiento clínico del carcinoma epidermoide del suelo de la boca.

Materiales y método

Se realizó un estudio retrospectivo utilizando los registros de pacientes diagnosticados de carcinoma de células escamosas del suelo de la boca entre 2000 y 2012 en el Hospital Universitario Virgen de las Nieves de Granada. En el estudio se incluyeron 93 pacientes con carcinoma epidermoide del suelo de boca tratados con tumorectomía y disección selectiva del cuello. Se analizó el patrón de distribución de las metástasis cervicales y numerosas características histológicas, como el estadio T, el estadio N, los márgenes quirúrgicos, el espesor tumoral, la diseminación extracapsular y la invasión vascular.

Resultados

El nivel I fue el más afectado, seguido del nivel II. El estadio T, el espesor tumoral y los márgenes quirúrgicos mostraron una fuerte relación con el riesgo de desarrollar una recidiva local o cervical durante el seguimiento. La supervivencia global fue del 52,7%. El estadio T, el espesor tumoral, el estadio N, la recurrencia, la diseminación extracapsular y la invasión vascular también se asociaron a un mal pronóstico.

Conclusión

El carcinoma epidermoide del suelo de la boca representa una enfermedad agresiva incluso en estadios tempranos. Debido a la baja tasa de ganglios positivos observada en los niveles IV y V en pacientes clínicamente N0, la disección supraomohioidea del cuello puede considerarse suficientemente segura en este grupo de pacientes.

Palabras clave:
Suelo de la boca
Carcinoma epidermoide oral
Comportamiento agresivo
Disección cervical supraomohioidea

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