Current surgical management of metastases in the neck from mucosal squamous cell carcinoma of the head and neck

Green, Ben; Bisase, Brian; Godden, Daryl; Mitchell, David A.; Brennan, Peter A.

doi:10.1016/j.bjoms.2015.06.025

Cited by 4 publications

(3 citation statements)

References 64 publications

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“…At present it is generally accepted that elective neck dissection is indicated for patients presenting with OSCC with a clinically N0 if the reported risk of occult metastases exceeds 15% - 20% [ 12 ]. Yet in most cases this may not be necessary [ 13 ]. In a study carried out by Shah et al 1990 revealed that even in the clinically node negative neck, nodal metastases were present in levels I-IV in up to 40% of neck dissections [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

A model to predict nodal metastasis in patients with oral squamous cell carcinoma

et al. 2018

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Difficulty in precise decision making on necessity of surgery is a major problem when managing oral squamous cell carcinomas (OSCCs) with clinically negative neck. Therefore, use of clinical and histopathological parameters in combination would be important to improve patient management. The main objective is to develop a model that predicts the presence of nodal metastasis in patients with OSCC.623 patients faced neck dissections with buccal mucosal or tongue squamous cell carcinoma (SCC) were selected from patients’ records. Demographic data, clinical information, nodal status, Depth of invasion (DOI) and pattern of invasion (POI) were recorded. The parameters which showed a significant association with nodal metastasis were used to develop a multivariable predictive model (PM). Univariate logistic regression was used to estimate the strengths of those associations in terms of odds ratios (OR). This showed statistically significant associations between status of the nodal metastasis and each of the following 4 histopathological parameters individually: size of the tumour (T), site, POI, and DOI. Specifically, OR of nodal metastasis for tongue cancers relative to buccal mucosal cancers was 1.89, P-value < 0.001. Similarly, ORs for POI type 3 and 4 relative to type 2 were 1.99 and 5.83 respectively. A similar relationship was found with tumour size; ORs for T2, T3, and T4 compared to T1 were 2.79, 8.27 and 8.75 respectively. These four histopathological parameters were then used to develop a predictive model for nodal metastasis. This model showed that probability of nodal metastasis is higher among tongue cancers with increasing POI, with increasing T, and with larger depths while other characteristics remained unchanged. The proposed model provides a way of using combinations of histopathological parameters to identify patients with higher risks of nodal metastasis for surgical management.

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Section: Discussionmentioning

confidence: 99%

A model to predict nodal metastasis in patients with oral squamous cell carcinoma

et al. 2018

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“…However, cervical lymph occult metastases have been reported in only between 20% and 44% of patients with head and neck squamous cell carcinoma and no sign of metastases in the neck. 11 Previously, Michael considered that it is necessary to perform neck dissection if the estimated risk of occult lymph node metastases exceeds 15%-20%. 12 However, this policy inevitably results in overtreatment in some patients, since the incidence of occult lymph node metastases in patients treated with elective neck dissections is only 10%-36%.…”

Section: Discussionmentioning

confidence: 99%

“…Neck dissection is an important part of surgical treatment for patients who have cervical lymph node metastasis. However, cervical lymph occult metastases have been reported in only between 20% and 44% of patients with head and neck squamous cell carcinoma and no sign of metastases in the neck 11 . Previously, Michael considered that it is necessary to perform neck dissection if the estimated risk of occult lymph node metastases exceeds 15%–20% 12 .…”

Section: Discussionmentioning

confidence: 99%

Radiomics based on magnetic resonance imaging for preoperative prediction of lymph node metastasis in head and neck cancer: Machine learning study

Wang

Yang

et al. 2022

Head & Neck

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Background In this study, we use machine learning techniques to develop an efficient preoperative magnetic resonance imaging (MRI) radiomics approach for evaluation of cervical lymph node (CLN) status. Methods After collecting all patients' MRI images, we used CLN radiomic features, the apparent diffusion coefficients (ADC) from diffusion‐weighted imaging (DWI), and lymph node short diameter of the CLN to build MRI model to predict the status of the CLN. Results One hundred and twenty cases met inclusion criteria. The MRI model including the radiomic features, ADC, and lymph node size of the CLN achieved better performance for CLN status prediction with the area under the receiver operating characteristic (ROC) curve (AUC) of 0.83. Conclusions The multiomic signature of MRI radiomics, ADC, and lymph node size of CLNs has high predictive value for the status of CLNs. This model has provided scientific value to the surgeon regarding cervical lymph nodes before surgery.

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The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma

Qian

Guo

Zheng

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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Current surgical management of metastases in the neck from mucosal squamous cell carcinoma of the head and neck

Cited by 4 publications

References 64 publications

A model to predict nodal metastasis in patients with oral squamous cell carcinoma

A model to predict nodal metastasis in patients with oral squamous cell carcinoma

Radiomics based on magnetic resonance imaging for preoperative prediction of lymph node metastasis in head and neck cancer: Machine learning study

The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma

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