Management of the Neck in Oral Squamous Cell Carcinoma

Afzali, Payam; Ward, Brent B.

doi:10.1016/j.coms.2018.09.004

Cited by 15 publications

(10 citation statements)

References 76 publications

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“…Tongue squamous cell carcinoma (SCC) is the most common oral cavity malignancy (1,2), its prognosis has not improved significantly despite advances in diagnosis and treatment, neck lymph node metastasis is one of the most important prognostic factors (3,4), but unfortunately these positive lymph nodes are usually occult or subclinical at the initial treatment in early stage tongue SCC. Owing to a wide range of occult metastasis rate (5, 6), either elective neck dissection (END) or the watchful waiting policy has been the favored treatment for cT1-2N0 tongue SCC (7, 8).…”

Section: Introductionmentioning

confidence: 99%

Lingual Lymph Node Metastasis in cT1-2N0 Tongue Squamous Cell Carcinoma: Is It an Indicator for Elective Neck Dissection

et al. 2020

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Objective: Accurate predictors for occult metastasis in cT1-2N0 tongue squamous cell carcinoma (SCC) remains scarce, the main goal in current study was to evaluate whether there is significant association between lingual lymph node (LLN) metastasis and occult lymph node metastasis as well as whether there is prognostic value of LLN metastasis in early stage tongue SCC. Methods: Patients with surgically treated primary cT1-2N0 tongue SCC were prospectively enrolled from January 2010 to December 2018. LLNs were dissected independently for pathologic analysis. The main study endpoints were locoregional control survival (LRC) and disease-specific survival (DSS). The Chi-square test and multivariate regression analysis were used to assess the predictors for occult metastasis. The Kaplan-Meier approach and Cox model were used to analyze the potential prognostic factors. Results: A total of 317 patients were enrolled for analysis. Eighty-eight patients had occult metastasis with a prevalence of 27.8%. LLNs presented in 89 patients, in which 43 patients had LLN metastasis. In the 43 patients with positive LLNs, 20 patients had occult metastasis, in 274 patients with negative LLNs or no LLNs, 68 patients had occult metastasis, the difference was significant (p = 0.012). Further multivariate regression analysis confirmed the independence of LLN metastasis in predicting the occult metastasis. In patients without LLNs, the 5-year LRC rate was 79%, in patients with negative LLNs, the 5-year LRC rate was 78%, in patients with positive LLNs, the 5-year LRC rate was 62%, the difference was significant (p = 0.024). In patients without LLNs, the 5-year DSS rate was 84%, in patients with negative LLNs, the 5-year DSS rate was 74%, in patients with positive LLNs, the 5-year DSS rate was 51%, the difference was significant (p < 0.001), further Cox model confirmed the independence of LLN metastasis in affecting the LRC and DSS. Conclusions: LLN metastasis is significantly associated with occult neck lymph node metastasis, and decrease the LRC and DSS in early stage tongue SCC.

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Section: Introductionmentioning

confidence: 99%

Lingual Lymph Node Metastasis in cT1-2N0 Tongue Squamous Cell Carcinoma: Is It an Indicator for Elective Neck Dissection

et al. 2020

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“…The approach to patients with early-stage OSCC and with cN0 has been a matter of controversy for several years [2,5]. Although there is a lack of global consensus amongst the published guidelines on the management of cN0 neck, there has been a growing trend in the literature towards upfront END in opposition to a "watch and wait policy" [2,7].…”

Section: Discussionmentioning

confidence: 99%

“…Oral squamous cell carcinoma (OSCC) is one of the most common cancers worldwide [1,2], and the tongue remains its most common subsite [2,3]. Since the most important factor in the prognosis of OSCC is the status of the regional nodes, and since the presence of nodal metastasis decreases patients' survival by nearly 50%, an adequate evaluation of neck disease by the surgeon is critically important [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Pretreatment Blood Markers in the Prediction of Occult Neck Metastasis: A 10-Year Retrospective Study

Ventura¹,

Barros²,

Salgado³

et al. 2021

Cureus

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The purpose of this study was to clarify the role of inflammatory blood markers in the management of earlystage (T1-T2) oral squamous cell carcinoma (OSCC) of the tongue in patients with a clinically negative neck. Materials and methodsWe undertook a retrospective chart review of 102 patients with early-stage OSCC of the tongue, subjected to tumor resection and elective neck dissection. Based on postsurgical histopathological examination results, we divided our cohort into pN+ and pN0 groups. Afterwards, we analyzed the role of pretreatment inflammatory blood markers in predicting occult neck metastasis. We also evaluated neutrophil-lymphocyte ratio (NLR) association with the depth of invasion (DOI) of the primary tumor. ResultsWe found a significant association of NLR (p=0.001) and monocyte-lymphocyte ratio (p=0.011) with neck status on univariate analysis. Multivariate analysis showed that only NLR (p=0.02) was an independent risk factor for occult metastasis among inflammatory blood markers. Receiver Operating Characteristic curve analysis and Younden's Index determined the NLR value of 2.96 as the most adequate cut-off value for neck status prediction. NLR values of pretreatment workup also had a significant association with the DOI of the primary tumor (p=0.018). ConclusionOur study supports the role of pretreatment NLR in predicting occult neck metastasis in early-stage OSCC of the tongue. It also sheds some light over the potential of NLR as a predictor of the primary tumor's DOI.

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“…Two-thirds of OSCC occurred in men 3. At the early stage, the standard treatment is effective for patients with OSCC; however, eventually, more than 50% of patients develop local recurrence or distant metastases, resulting in a poor prognosis 4,5. Therefore, development of novel therapeutic strategies for patients with advanced OSCC, and further elucidation of the molecular mechanism that promotes the malignancy of OSCC, are urgently needed.…”

Section: Introductionmentioning

confidence: 99%

<p>Androgen receptor promotes oral squamous cell carcinoma cell migration by increasing EGFR phosphorylation</p>

Liu¹,

Qing²,

Che³

et al. 2019

OTT

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Objectives: This study is aimed to investigate the role of androgen receptor (AR) in regulating oral squamous cell carcinoma (OSCC) cells migration. Materials and methods: Tumors from 23 patients with OSCC and five OSCC cell lines were used for analyzing AR expression. The effects of AR agonist and antagonist were used to examine the role of AR in regulating the migration of OSCC cells. Results: Ten of 23 tumors from patients with OSCC were AR positive. There was no significant difference in total EGFR (tEGFR) expression between AR-positive tumors and AR-negative tumors. However, the expression of phosphorylated EGFR (pEGFR) in AR-positive tumors was significantly higher than that in AR-negative tumors ( p <0.01). Stimulation of AR by dihydrotestosterone in SCC9 (AR-positive OSCC cell) caused an increase in pEGFR and pAKT expression and promoted cell migration without changed tEGFR expression, whereas treatment with bicalutamide led to a decrement in pEGFR expression and pAKT and inhibited cell migration. No effects were found in SCC25 cell line (AR-negative) either treated by dihydrotestosterone or bicalutamide. Furthermore, SCC9 cell line treated by EGF or cetuximab (EGFR inhibitor) significantly promoted or inhibited cell migration. Conclusion: Our data indicate that OSSC tumors and OSCC cell lines express AR which is critical for promoting cell migration by increasing EGFR phosphorylation.

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Management of the Neck in Oral Squamous Cell Carcinoma

Cited by 15 publications

References 76 publications

Lingual Lymph Node Metastasis in cT1-2N0 Tongue Squamous Cell Carcinoma: Is It an Indicator for Elective Neck Dissection

Lingual Lymph Node Metastasis in cT1-2N0 Tongue Squamous Cell Carcinoma: Is It an Indicator for Elective Neck Dissection

Pretreatment Blood Markers in the Prediction of Occult Neck Metastasis: A 10-Year Retrospective Study

<p>Androgen receptor promotes oral squamous cell carcinoma cell migration by increasing EGFR phosphorylation</p>

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