The Depth of Invasion and Level IV Cervical Node Metastasis in Patients with Clinically N0 Tongue Cancer.

BACKGROUND: The accurate indication for level IV dissection is crucial for preventing complications such as phrenic nerve damage and chylous fistulas in clinically N0 tongue cancer. Although the depth of invasion is an established independent risk factor for occult lymph node metastasis in tongue cancer, its relationship with level IV metastasis has not been evaluated. This study investigated the relationship between the depth of invasion and level IV nodal metastasis in clinically N0 tongue cancer. METHODS: We retrospectively investigated clinical N0 patients who underwent glossectomy and level I-IV neck dissection. We examined lymph node metastasis, risk factors, and the relationship between depth of invasion and metastasis. RESULTS: Our study included 58 patients, and no patient had isolated level IV metastasis. Additionally, there was no level IV metastasis in well-differentiated tumors. Tumor size, depth of invasion, differentiation, and perineural invasion were significantly associated with level IV neck metastasis. We found a critical tumor size of 2.5 cm and depth of invasion of 8 mm for level IV neck metastasis. CONCLUSION: Based on our findings, we recommend that level IV dissection should be considered for poorly differentiated tumors, tumors greater than 2.5 cm in size, and those deeper than 8 mm. This study highlights the importance of depth of invasion as a prognostic factor for predicting level IV metastasis and suggests that our findings can be used to prevent unnecessary level IV dissections that may lead to complications in tongue cancer surgery.

The Bibliometric Analysis of the Studies Presented at the Turkish National Otorhinolaryngology Congresses in the Period 2009-2018.

OBJECTIVE: The aim of this study was to quantitatively and qualitatively analyze the abstracts presented at Turkish National Otorhinolaryngology Congresses in the years from 2009 to 2018. METHODS: Abstracts were defined and grouped according to their field of study, design, level of evidence, number of authors, the main institution in which they were held, and whether they were uni- or multi-centric. Frequency and percentage tables were prepared. RESULTS: In total, 5,463 studies, of which 1,431 (26.2%) were oral presentations and 4,032 (73.8%) were poster presentations were reviewed. The highest number of studies was in the field of otology and in the form of oral presentations (32%), and in the field of head and neck surgery in the form of poster presentations (37%). Fifty-seven percent of all studies were conducted in university hospitals, and 34% in Training and Research Hospitals. Eighty-three percent of oral presentations and 99% of poster presentations were clinical studies. The rate of experimental animal studies was 16% in oral presentations. The most commonly used design of orally presented clinical studies was descriptive (31%), whereas prospective randomized controlled design was the least common (3%). No study with a level 1 of evidence was found. The rate of oral papers presented with evidence levels 2, 3, 4, and 5 among all oral presentations were 22%, 13%, 11%, and 54%, respectively. CONCLUSION: The findings indicated that the abstracts were satisfactory in quantity, but overall scientific quality was not sufficient. The data obtained may serve as a basis for future studies, and follow-up studies may guide individuals and institutions that steer the Turkish ENT community.