Metastasis Leher Tersembunyi pada Karsinoma Lidah T1-T2

Abstract

Abstrak

Karsinoma lidah memiliki kecenderungan yang tinggi untuk bermetastasis ke limfonodi leher, bahkan pada stadium awal (T1-T2). Tidak ada metode imaging atau pemeriksaan lain yang dapat mendeteksi metastasis leher tersembunyi. Ketebalan atau kedalaman invasi tumor adalah satu-satunya kriteria prediktor metastasis nodal pada karsinoma lidah dengan nilai cut offberkisar antara 3-9 mm. Diseksi Leher Selektif (DLE) level I-III "Diseksi Leher Supraomohioid" (DLSOH) telah direkomendasikan sebagai terapi utama karsinoma lidah stadium awal dengan klinis Node negatif (N0). Hanya pada sebagian kecil kasus yang mengalami metastasis ke level IV yang dikenal dengan “skip metastasis”,extended supraomohyoid neck dissectionlevelI-IV direkomendasikan oleh beberapa penulis. Diseksi leher bilateral harus dilakukan bila telah melibatkan struktur midline lidah.

Kata kunci: karsinoma lidah, metastasis leher tersembunyi, diseksi leher supraomohioid

Abstract
Carcinoma of tongue has a high propensity for nodal metastasis in the neck, even in early stages (T1–T2). There is no method of imaging or other examination that will detect occult nodal metastasis. Tumor thickness or depth of invasion is the only size criterion predictor of nodal metastasis in carcinoma of tongue, the critical cut off values ranged from 3 to 9 mm. Selective dissection of levels I–III “supraomohyoid neck dissection” has been recommended as a primary treatment of neck disease in early carcinoma of tongue with clinically N0 neck. Most of the relatively small number of isolated metastasis to level IV are from primary tumours of the tongue, which are known as “skip metastasis”. Thus an extended supraomohyoid neck dissection of levels I–IV is recommended by some authors for elective treatment of the neck in carcinoma of tongue. Bilateral neck dissection should be performed in elective treatment of tumours involving midline structure.
Keywords : carcinoma of tongue, occult nodal metastasis, supraomohyoid neck dissection