Management of the Contralateral Neck in Oral Squamous Cell Carcinoma in the UK and a Review of Literature

Abstract

Oral squamous cell carcinoma (OSCC) has a variable incidence of contralateral neck (CLN) metastases which affects long-term survival and prognosis. Therefore, due consideration should be given to the management of the CLN in OSCC for certain cases. Neck dissection is often indicated in the N0 cases where the primary OSCC obviously crosses the midline. However, there is much variability in the management of the CLN when considering two other clinical events encountered in multidisciplinary meetings. These were interrogated by conducting an online survey in the UK. The first scenario included a tumour close to but not crossing the midline and the second included an ipsilateral metachronous or recurrent tumour when the ipsilateral neck (ILN) had been previously treated. The respondents included head and neck (H&N) consultant clinicians in the UK. Our findings suggest wide inconsistencies in the management of the CLN in these particular situations. The variability in practice is also reflected in the literature review. There is a need to address the CLN. There may be a role for sentinel lymph node biopsy (SLNB) in staging the neck for tumours close to the midline or in ipsilateral metachronous tumour or recurrence in a patient with a previously treated ILN.