Elective Neck Dissection Versus Therapeutic Neck Dissection in Clinically Node-Negative Early Stage Oral Cancer: A Meta-analysis of Randomized Controlled Trials

Kumar, Ajay; Ghai, Suhani; Mhaske, Shubhangi; Singh, Rajeev Kumar

doi:10.1007/s12663-021-01677-z

Cited by 12 publications

(5 citation statements)

References 40 publications

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“…A meta‐analysis showed that for patients with T1‐2N0 OTSCC, LND can significantly prevent local recurrence and thus increase disease specific survival but not OS 29 . Another meta‐analysis including 1250 patients (7 randomized controlled trials) in early‐stage OSCC with clinical N0 patents found that in comparison to observation, elective neck dissection could significantly improve OS and DSS, and significantly reduce lymph node recurrence 30 . Furthermore, the number of LND is also important for better outcome.…”

Section: Discussionmentioning

confidence: 99%

“…29 Another meta-analysis including 1250 patients (7 randomized controlled trials) in early-stage OSCC with clinical N0 patents found that in comparison to observation, elective neck dissection could significantly improve OS and DSS, and significantly reduce lymph node recurrence. 30 Furthermore, the number of LND is also important for better outcome. Cheng et al 31 noted that the survival outcome was significantly higher in the group with ≥37 retrieved lymph nodes for patients of T1-2N0M0 oral cancer.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Wang,

Zeng

et al. 2024

Cancer Medicine

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PurposeThe study aimed to retrospectively identify the prognostic factors of surgically treated primary tongue squamous cell carcinoma (TSCC) cases and assess the benefits of surgical neck lymph node dissection (LND) in early‐stage cancer.MethodsPatients with primary TSCC with pT1‐2N0‐1M0 stage without distant metastasis who were treated with surgery during 2014–2016 at Xiangya Hospital, Central South University were included. Univariate and multivariate Cox models were constructed to explore prognostic factors of overall survival (OS), disease‐free survival (DFS), and local recurrence‐free survival (LRFS). Sub‐group analysis was used to assess the effect of adjuvant therapy and the prognostic value of LND for the early‐stage patients.ResultsIn total, 440 patients met the inclusion criteria. During the follow‐up period, the 5‐year OS, DFS, were 84.4% and 70.0%, respectively. Univariate analysis showed that TNM stage, lymphovascular invasion (LVI), and/or perineural invasion (PNI), pathological differentiation, etc. were significant predictors of OS and DFS. Multivariate analysis showed that TNM stage and the degree of pathological differentiation were independent prognostic factors for all outcomes. Besides, the number of cervical LND could independently predict both DFS and LRFS while LVI/PNI were associated with DFS. And high‐quality neck LND (≥30) significantly improved DFS and LRFS for patients of pT1cN0M0 or stage I as compared to those without LND.ConclusionsTNM stage and pathological differentiation were crucial prognostic factors for postoperative patients with TSCC. Notably, high‐quality cervical LND was beneficial for the improvement of DFS and LRFS for patients of pT1cN0M0 or stage I.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Wang,

Zeng

et al. 2024

Cancer Medicine

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“…In patients with earlystage OSCC (T1-T2N0), occult metastases in the neck are present in up to 20%-40% of patients, therefore leading to elective neck dissection (END) as the standard of care for early-stage OSCC in many medical centers. 10,[13][14][15][16] After END and TND, the rate of recurrence in the neck is relatively high for patients with OSCC, 13%-30% in early-stage and 40% in N+ disease. Combined therapy (post-operative radiotherapy (RT) or chemo-radiotherapy [CRT]) is used as a common treatment standard for OSCC stage II and above.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with early‐stage OSCC (T1–T2N0), occult metastases in the neck are present in up to 20%–40% of patients, therefore leading to elective neck dissection (END) as the standard of care for early‐stage OSCC in many medical centers. 10 , 13 , 14 , 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

Sentinel node‐assisted neck dissection in advanced oral squamous cell carcinoma—A new protocol for staging and treatment

et al. 2023

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“…In recent years, the incorporation of depth of invasion into the T classification of primary lesions in OSCC staging has been observed as being useful in predicting such risks. There is some controversy over the use of prophylactic neck dissection [4][5][6], with no clear conclusions reached, and use depends largely on each respective institution's policies.…”

Section: Introductionmentioning

confidence: 99%

Comparing the Diagnostic Accuracy of Ultrasonography, CT, MRI, and PET/CT in Cervical Lymph Node Metastasis of Oral Squamous Cell Carcinoma

Takamura,

Nikkuni,

Hayashi

et al. 2023

Biomedicines

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(1) Background: In oral cancer staging, ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), and 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) with positron emission tomography/computed tomography (PET/CT) are routinely used in clinical practice. The present study is a retrospective examination of the diagnostic accuracy of cervical lymph node metastasis using US, CT, MRI, and PET/CT, with histopathological diagnosis as a reference, to compare the different diagnostic imaging modalities. (2) Methods: The participants included 16 patients with oral squamous cell carcinoma who underwent US-, CT-, MRI-, and PET/CT-based preoperative diagnostic imaging and simultaneous primary lesion resection and neck dissection, including 82 level regions and 424 lymph nodes. We compared the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of each imaging modality based on the imaging results and the pathology results of metastasis. (3) Results: Of the four diagnostic imaging modalities, PET/CT exhibited the highest sensitivity but the lowest specificity and accuracy. US, CT, and MRI had high specificities. Comparing each level region and lymph node showed that differences were observed in PET/CT. (4) Conclusions: PET/CT to diagnose lymph node metastasis requires a comprehensive evaluation because it produces more false positives than other diagnostic imaging modalities. Using US, CT, and MRI, which have excellent spatial resolution, improves diagnostic accuracy at the lymph node level.

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Elective Neck Dissection Versus Therapeutic Neck Dissection in Clinically Node-Negative Early Stage Oral Cancer: A Meta-analysis of Randomized Controlled Trials

Cited by 12 publications

References 40 publications

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

Sentinel node‐assisted neck dissection in advanced oral squamous cell carcinoma—A new protocol for staging and treatment

Comparing the Diagnostic Accuracy of Ultrasonography, CT, MRI, and PET/CT in Cervical Lymph Node Metastasis of Oral Squamous Cell Carcinoma

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