Is a “watch and wait strategy” safe to manage clinically N0 squamous cell carcinoma of the upper jaw?

Cariati, Paolo; Cabello-Serrano, Almudena; Monsalve-Iglesias, Fernando; Fernadez-Solis, Jose; Martínez-Lara, Ildefonso

doi:10.1016/j.currproblcancer.2018.10.004

Cited by 5 publications

(11 citation statements)

References 15 publications

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“…There are variances in the survival rates of different tumour orientations [ 4 ]. Controversy sexist in the management of T2N0M0 OSCC arising from maxillary gingiva, alveolus, and hard palate [ 23 ]. The low incidence of cervical metastases has historically been considered a hallmark of this disease, and a “watch-and-wait” strategy is typically used to control neck lymph node metastases [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Elective neck dissection improves the survival of patients with T2N0M0 oral squamous cell carcinoma: a study of the SEER database

et al. 2021

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Background Treatment of clinical N0 neck tumours is controversial in early-stage oral squamous cell carcinoma (OSCC), possibly because T1N0M0 and T2N0M0 merge together at early stages. The purposes of this study were to compare survival outcomes only for T2N0M0 cases based upon treatment elective neck dissection versus neck observation. Methods T2N0M0 OSCC cases were identified in the Surveillance, Epidemiology, and End Results database of the United States National Cancer Institute between 2004 and 2015. Survival curves for different variable values were generated using Kaplan-Meier estimates and compared using the log-rank test. Variables that achieved significance at P < 0.05 were entered into multivariable analyses via the Cox proportional hazards multivariate regression. Results A total of 2857 patients were selected, and 2313 cases were available for disease specific survival (DSS). The 5-year and 10-year overall survival (OS) were 66.7 and 46% for patients receiving elective neck dissection (END), respectively, and 56.4 and 37.2% for patients with neck observation (P < 0.0001). The 5-year and 10-year DSS were 73.6 and 64% for the END group, respectively, versus 64.5 and 54.5% for the neck observation group (P < 0.0001). More importantly, performing END was independently associated with favourable DSS and OS for patients with T2N0M0 OSCC [hazard ratio (HR) = 0.769, P = 0.0069 for DSS; HR = 0.829, P = 0.0031 for OS, neck observation group as reference] according to multivariate survival analysis. Conclusion END is recommended for T2N0M0 OSCC cases and it is associated with improved DSS and OS.

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Section: Discussionmentioning

confidence: 99%

Elective neck dissection improves the survival of patients with T2N0M0 oral squamous cell carcinoma: a study of the SEER database

et al. 2021

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“…In terms of sensitivity and specificity, CD36 showed a promising sensitivity (80%) and specificity (86%) in univariate prediction of lymph node metastasis. In OSCC, there are constellations where the question of the necessity or feasibility of a neck lymph node dissection arises, for example, a T1 or T2 tumor in the region of the alveolar process of the upper jaw [10,11,32]. T1 und T2 tumors with a high CD36 also showed a strong correlation with the existence of lymph node metastasis (Table 6).…”

Section: Discussionmentioning

confidence: 99%

“…The extension and requirement of a neck dissection in UICC I or II cases, especially in the upper jaw, is debated [10,11]. The treatment decision is made using the TNM or UICC classification based on CT-based staging and clinical impression.…”

Section: Introductionmentioning

confidence: 99%

Fatty Acid Receptor CD36 Functions as a Surrogate Parameter for Lymph Node Metastasis in Oral Squamous Cell Carcinoma

Haidari

Tröltzsch

Knösel

et al. 2021

Cancers

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Purpose: To investigate the expression pattern of CD36 in a patient population with oral squamous cell carcinoma (OSCC) and to correlate CD36 expression with clinical and histopathological parameters. The hypothesis was that CD36 expression correlates with the occurrence of lymph node metastasis. Methods: To address the study objectives, a retrospective cohort study was conducted. Study variables included demographic, histopathological and survival data. CD36 expression patterns were assessed by immunohistochemistry on tissue microarrays (TMA). Logistic regression analysis, survival analysis and Cox proportional hazards model were performed. Results: High CD36 expression correlated significantly with a higher T-status, grading and occurrence of lymph node metastasis. The logistic regression with binary N status as a dependent variable showed that high CD36 expression increased the chance for lymph node metastasis 45-fold (OR = 44.7, 95% CI: 10.0–316). Patients with high CD36 expression had lower probabilities of progression-free survival. CD36 had a small and non-significant independent influence on progression-free survival. Conclusions: CD36 is expressed in OSCC and correlates with tumor grading, T-status, and especially the occurrence of lymph node metastasis. CD36 may be useful for risk stratification regarding lymph node metastasis in OSCC.

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“…At diagnosis, approximately 69.7% of these tumors are detected without cervical metastasis (cN0), and cervical dissection is usually not indicated or performed. 9,10 However, recent studies have shown that there may be hidden metastases in 21% to 42.9% of cases. Additionally, 64% of these metastases may occur in the first year after treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, 64% of these metastases may occur in the first year after treatment. 6,9,10 In light of these data, currently, two treatment strategies are followed: "watch-and-wait" and END. 9,11,12 The "watch-and-wait" approach in the cN0 neck consists of performing surgical treatment to control the tumor locally, followed by a rigorous follow-up and careful observation of the primary tumor location and the neck.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors of Squamous Cell Carcinoma in Hard Palate, Gingiva, and Upper Alveolar Ridge

Kovalski¹,

Zanella²,

Jardim³

et al. 2022

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Is a “watch and wait strategy” safe to manage clinically N0 squamous cell carcinoma of the upper jaw?

Cited by 5 publications

References 15 publications

Elective neck dissection improves the survival of patients with T2N0M0 oral squamous cell carcinoma: a study of the SEER database

Elective neck dissection improves the survival of patients with T2N0M0 oral squamous cell carcinoma: a study of the SEER database

Fatty Acid Receptor CD36 Functions as a Surrogate Parameter for Lymph Node Metastasis in Oral Squamous Cell Carcinoma

Prognostic Factors of Squamous Cell Carcinoma in Hard Palate, Gingiva, and Upper Alveolar Ridge

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