Abstract:Background: The incidence of oral squamous cell carcinoma (OSCC) is increasing, with an estimated 369,000 new patients each year worldwide. Surgery is the primary treatment modality for early-stage OSCC, but there is scant evidence to prove the value of elective neck dissection (END) for relatively small early-stage OSCC. This study aimed to identify factors predicting survival for patients with clinical stage T1N0M0 (cT1N0M0) OSCC and whether up-front END improved survival. Patients and Methods: Patients with… Show more
“…As shown in Table 1 , except for sex, the dead/alive ratio for age, race, marital status, primary sites, T stage, M stage, surgery, radiation, and chemotherapy were significantly different between the END group and the No END group, both for OS and DSS. These results were consistent with previous studies [ 13 ]. Fig.…”
Section: Resultssupporting
confidence: 94%
“…Several studies have investigated cN0 OSCC patients within this database [ 26 ]. Alimujiang et al performed two SEER-based analyses comparing END and observation in cT1N0 or T2N0 OSCC patients separately [ 13 , 27 ]. Through survival analysis and the Cox regression model, they showed that END was an independent prognostic indicator, improving both DSS and OS.…”
Background
The neck management of clinical-nodal negative (cN0) oral squamous cell carcinoma (OSCC) remains controversial. Elective neck dissection (END) and observation are the main strategies, but it is still not clear who could benefit the most from END. The purpose of this study was to clarify the potential clinical factors that affect the therapeutic value of END and to explore the actual characteristics associated with benefit from END.
Methods
Patients with cN0 OSCC were identified in the SEER database from 2000 to 2019. 5-year Overall survival (OS) and disease-specific survival (DSS) were analyzed using the Kaplan‒Meier method, and the hazard ratios (HRs) for survival were estimated using the Cox regression model. Multiple subgroup analyses of DSS and OS among different factors, comparing END and No END, were performed.
Results
A total of 17,019 patients with cN0 OSCC were included. The basic survival analysis and Cox regression model showed that END increased the probability of 5-year DSS and OS and was an independent prognostic factor. However, among patients who underwent only primary tumor surgery, no significant differences were found between the END and No END groups in 5-year DSS (P = 0. 585) and OS (P = 0.465). Further subgroup analysis showed that primary sites and T stage, but not other factors, might influence the benefit of END. Significant differences were found for T1 (P < 0.001 for OS) and T2 (P = 0.001 for DSS and < 0.001 for OS) tongue squamous cell carcinoma (TSCC) but not for other primary tumor sites.
Conclusion
This large-scale retrospective population-based cohort study suggests that not all patients with cN0 OSCC could benefit from END. Patients with cN0 TSCC are recommended to undergo END, especially with early-stage tumors.
“…As shown in Table 1 , except for sex, the dead/alive ratio for age, race, marital status, primary sites, T stage, M stage, surgery, radiation, and chemotherapy were significantly different between the END group and the No END group, both for OS and DSS. These results were consistent with previous studies [ 13 ]. Fig.…”
Section: Resultssupporting
confidence: 94%
“…Several studies have investigated cN0 OSCC patients within this database [ 26 ]. Alimujiang et al performed two SEER-based analyses comparing END and observation in cT1N0 or T2N0 OSCC patients separately [ 13 , 27 ]. Through survival analysis and the Cox regression model, they showed that END was an independent prognostic indicator, improving both DSS and OS.…”
Background
The neck management of clinical-nodal negative (cN0) oral squamous cell carcinoma (OSCC) remains controversial. Elective neck dissection (END) and observation are the main strategies, but it is still not clear who could benefit the most from END. The purpose of this study was to clarify the potential clinical factors that affect the therapeutic value of END and to explore the actual characteristics associated with benefit from END.
Methods
Patients with cN0 OSCC were identified in the SEER database from 2000 to 2019. 5-year Overall survival (OS) and disease-specific survival (DSS) were analyzed using the Kaplan‒Meier method, and the hazard ratios (HRs) for survival were estimated using the Cox regression model. Multiple subgroup analyses of DSS and OS among different factors, comparing END and No END, were performed.
Results
A total of 17,019 patients with cN0 OSCC were included. The basic survival analysis and Cox regression model showed that END increased the probability of 5-year DSS and OS and was an independent prognostic factor. However, among patients who underwent only primary tumor surgery, no significant differences were found between the END and No END groups in 5-year DSS (P = 0. 585) and OS (P = 0.465). Further subgroup analysis showed that primary sites and T stage, but not other factors, might influence the benefit of END. Significant differences were found for T1 (P < 0.001 for OS) and T2 (P = 0.001 for DSS and < 0.001 for OS) tongue squamous cell carcinoma (TSCC) but not for other primary tumor sites.
Conclusion
This large-scale retrospective population-based cohort study suggests that not all patients with cN0 OSCC could benefit from END. Patients with cN0 TSCC are recommended to undergo END, especially with early-stage tumors.
“…OSCC is thought to be responsible for more than 90% of all oral neoplasms [6]. According to the current study results, year survival rates for OSCC range from 50 to 60%, depending on a number of factors such as the patient's lifestyle, the timing of diagnosis, and the location of the primary tumor [7,8]. As a consequence, OSCC is linked with a poor prognosis in the medical community.…”
One of the most prevalent forms of oral cancer is oral squamous cell carcinoma (OSCC), a major cause of morbidity and mortality worldwide. Following a definite oral cancer diagnosis, OSCC is typically treated with a multidisciplinary approach including surgery, chemotherapy, and radiation. In contrast, conventional chemotherapy medicines may be ineffective and have a range of side effects. Many techniques have been proved and authorized for treatment and diagnostics of different types of oral cancer, while others are currently being investigated in clinical trials. This book chapter is aimed to explain the current preclinical status of nano-based techniques to successfully diagnose and treat OSCC. This book chapter would also emphasize recent theranostics approaches utilized to cure OSCC. Nanotechnology also improved cancer biomarker detection, making them faster and more sensitive. To overcome these constraints and improve in situ drug delivery, various nanoparticles have been employed as innovation drivers.
ObjectiveAlthough neck dissection has evolved to become an integral part of the surgical armamentarium for managing head and neck cancers, the manner in which the procedure has reached its present state is worth revisiting.Data SourcesPublished original articles, reviews, clinical practice guidelines, and consensus statements related to the basis, indication, and classification of the neck dissection.MethodsThis review discusses some of the critical milestones before and after the description of the procedure of neck dissection by George Crile Sr. in 1905, which eventually played a role in the evolution of this commonly performed oncosurgical procedure.ResultsSeveral large observational studies of the twentieth century and multicentric randomized trials at the turn of the twenty‐first century have shaped neck dissection into a safe and reliable oncosurgical procedure.ConclusionsFrom being a radical surgery that was done mostly in large nodal diseases for curative or palliative purposes to becoming a simple procedure that is carried out even in node‐negative cases of head and neck cancers for prognostic purposes, the procedure of neck dissection has come a long way and continues to evolve.
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