Within 2 weeks of CT scan, surgical removal of MLNs and MRLNs was performed bilaterally. Surgery was performed by a board-certified dentist and oral surgeon (SG) or board-certified oncologic surgeon (PA). Surgery was performed through two lateral incisions or a single ventral incision depending on surgeon preference. Intra- and post-operative complications were recorded.
Resected LNs were submitted for histopathological evaluation by a single board-certified pathologist (CB). Sectioning of LNs was performed as serial 2.5mm cross sections perpendicular to the long axis. All resulting pieces of tissue were processed, embedded, stained with hematoxylin and eosin, and examined histologically. Exceptions were made for LNs that were grossly enlarged, abnormal, and considered likely metastatic. For these LNs, representative sections were sampled to confirm metastasis, identify the tissue as LN origin, and determine presence or absence of extra-nodal extension. Histopathology results were reported as micro (< 2mm) or macro (>2 mm) metastasis.
Resected LNs were submitted for histopathological evaluation by a single board-certified pathologist (CB). Sectioning of LNs was performed as serial 2.5mm cross sections perpendicular to the long axis. All resulting pieces of tissue were processed, embedded, stained with hematoxylin and eosin, and examined histologically. Exceptions were made for LNs that were grossly enlarged, abnormal, and considered likely metastatic. For these LNs, representative sections were sampled to confirm metastasis, identify the tissue as LN origin, and determine presence or absence of extra-nodal extension. Histopathology results were reported as micro (< 2mm) or macro (>2 mm) metastasis.
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