Prophylactic neck dissection in squamous cell carcinoma of oral tongue: A prospective randomized study

Fakih, Abdul R.; Rao, Renuka; Patel, Akshar

doi:10.1002/ssu.2980050507

Cited by 73 publications

(57 citation statements)

References 8 publications

(8 reference statements)

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“…This is in agreement with other reviews of SCCOT that demonstrate an incidence of occult lymph node disease of 20 -40%. [27][28][29][30][31][32][33] Although the presence of occult lymph node disease leads to stage migration, the presence of a single occult-positive lymph node did not have significant adverse effects on disease-specific survival in our study. In a review of 967 neck dissections, Byers 34 reported similar results when pathologic N1 disease was confined to the lymph node capsule.…”

Section: Discussionmentioning

confidence: 93%

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Greenberg

Naggar

et al. 2003

Cancer

164

116

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At present, storage capacities of single tank and tank farm have been greatly increasing. This change poses a real challenge for the applicability of current design standards. This article focuses on the applicability of safety spacing between tanks, which is one of the most important parameters of tank farm safety design. Taking PHAST and FDS as main research tools, the consequences of representative accidental scenarios were evaluated for different sizes of oil tanks to study the safety performance change caused by the increase of capability. The research results show that, when current standards are used to design the safety spacing between tanks, the safety performance increases as the capability increases. Considering the high property density, it is suggested that a higher safety performance objective has to be chosen when designing the safety spacing for ultra‐large oil tanks. © 2012 American Institute of Chemical Engineers Process Saf Prog, 2012.

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Section: Discussionmentioning

confidence: 93%

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Greenberg

Naggar

et al. 2003

Cancer

164

116

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“…They found that there was no survival difference between the two groups. They however found that a tumor depth of >4 mm was associated with higher rates of involved nodes and suggested that these set of patients may benefit from END [2]. A more recent RCT from Hong Kong compared END (supra-omohyoid neck dissection) versus observation for T1 and T2 lesions of the oral tongue.…”

Section: Discussionmentioning

confidence: 99%

“…To date four randomized control trials (RCT) have been conducted to address this issue. Two of these included only cancer of the tongue [2,3] and the other two [4,5] have included other early cancers of the oral cavity. However, the results of these trials have not provided a satisfactory answer to the controversy.…”

Section: Introductionmentioning

confidence: 99%

“…Fakih et al found that a tumor depth of greater than 4 mm was associated with higher potential of lymph nodal metastasis. They however did not find a survival difference if these patients were observed or subjected to END [2]. Studies have shown that a significant number of patients with early oral cavity cancers who are observed will develop neck recurrence and many of these patients will be of advanced stage with poor prognostic factors such as extra-capsular spread (ECS) [6].…”

Section: Introductionmentioning

confidence: 99%

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To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study

Vijayakumar

Burrah

Sabitha

et al. 2011

Indian J Surg Oncol

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Squamous cell carcinoma (SCC) of the tongue is a common cancer across the globe. These cancers have a high predilection for nodal metastasis and a high incidence of occult metastasis. The management of clinically negative neck nodes (N0) remains controversial. We have undertaken a prospective study to evaluate the rate of occult nodal metastasis, the characteristic of metastasis, and assess the usefulness of tumor depth as a predictor of metastasis and as a guide to treat the neck. Prospective study between January 2000 to December 2005. Patients with SCC of the anterior 2/3rd of tongue with N0 neck were included. Wide excision of the primary and subsequent modified radical neck dissection (in patients with tumor depth>4 mm) was performed. Postoperative radiotherapy was given in patients with lymph node metastasis. Patients who had no node metastasis (p N -ve) were observed. The total number of eligible patients was 180. Occult lymph node metastasis (p N +ve) was seen in 122 (62.2%) patients (p<0.001), multiple levels of node involvement in 79 (70.5%) patients and extracapsular spread (ECS) in 38 (33.6%) patients. Patients in the p N +ve group who were disease free was 63.1% as compared to 68.2% in the p N -ve group (p=0.36). Recurrence was seen in 28 (36.8%) patients of p N +ve group and 14 (31.8%) patients of p N -ve group. Early cancer of tongue with tumor depth >4 mm was associated with predominantly high grade tumors, high incidence of occult nodal metastasis, multiple levels of nodal involvement and ECS. The disease free status of patients with occult metastasis who were treated was similar to that of patients with no nodal metastasis. Elective neck dissection appears essential for early oral tongue cancer with tumor depth >4 mm as there is no investigational modality which can reliably identify patients without occult metastasis.

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“…The rate of nodal metastasis is higher in tongue cancer patients than oral cavity cancer patients whose rate is 30% on their initial evaluation (8,9). Several studies have shown a high rate of occult nodal metastasis (20-40%) in tongue SCC patients with no evidence of regional spread on clinical or radiographic evaluation (8,(10)(11)(12)(13)(14)(15). There is a tendency that tongue cancer increases in young females in recent 2-3 decades (16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Enhancement of active MMP release and invasive activity of lymph node metastatic tongue cancer cells by elevated signaling via the TNF-α-TNFR1-NF-κB pathway and a possible involvement of angiopoietin-like 4 in lung metastasis

Tanaka

Imamura

Yoneda

et al. 2016

International Journal of Oncology

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Abstract.To study the role of TNF-α in tongue cancer metastasis, we made highly metastatic cells from a human oral squamous cell carcinoma cell line (SAS) by repeating the passage in which the cells were injected into a nude mouse tongue and harvested from metastasized cervical lymph nodes. Cancer cells after 5 passages (GSAS/N5) increased invasive activity 7-fold in a TNF-α receptor 1 (TNFR1)-dependent manner and enhanced mRNA expression of TNF-α and TNFR1. In the highly metastatic cells, NF-κB activation was upregulated via elevated phosphorylation of Akt and Ikkα/β in the signaling pathway and secretion of TNF-α, active MMP-2 and MMP-9 increased. Suppression of increase of TNF-α mRNA expression and MMP secretion by NF-κB inhibitor NBD peptide suggested a positive feedback loop in GSAS/N5 cells; TNF-α activates NF-κB and activated NF-κB induces further TNF-α secretion, leading to increase of active MMP release and promotion of invasion and metastasis of the cells. GSAS/N5 cells that had been injected into the nude mouse tongue and harvested from metastasized lungs multiplied angiopoietin-like 4 (Angptl4) expression with enhanced migration activity, which indicated a possible involvement of Angptl4 in lung metastasis of the cells. These results suggest that TNF-α and Angptl4 promote metastasis of the oral cancer cells, thus, these molecules may be therapeutic targets for patients with tongue cancer. IntroductionThe American Cancer Society estimated 45,780 new cases of oral cavity and pharyngeal cancer, and 8,650 deaths from these tumors, in 2015 in the United States (1). By advances in surgery and radiation therapy, the 5-year survival rate for oropharyngeal cancer has increased to 66%, but the rate is still unsatisfactory in comparison with some other site cancers including prostate, thyroid and breast; the rates of these types of cancer are >90% (1). A primary cause for the unfavorable prognosis is patient death from the cancer metastasized at regional and distant sites (2-5). Squamous cell carcinoma (SCC) accounts for approximately 90% of oral and oropharyngeal malignancies in the United States and tongue is a common site of the malignant diseases (6,7). The rate of nodal metastasis is higher in tongue cancer patients than oral cavity cancer patients whose rate is 30% on their initial evaluation (8,9). Several studies have shown a high rate of occult nodal metastasis (20-40%) in tongue SCC patients with no evidence of regional spread on clinical or radiographic evaluation (8,10-15). There is a tendency that tongue cancer increases in young females in recent 2-3 decades (16-18). Thus, metastasis suppression is a main and urgent subject in the treatments of patients with tongue SCC.The process of metastasis is complex and involves tumor growth, the extra-cellular matrix breakdown, invasion to the vessels, escape from immune surveillance, transport to other sites with adhesion to the vessel, subsequent invasion into an organ where tumor cells proliferate, grow and spread. Various molecules participate in the pr...

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Prophylactic neck dissection in squamous cell carcinoma of oral tongue: A prospective randomized study

Cited by 73 publications

References 8 publications

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma

To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study

Enhancement of active MMP release and invasive activity of lymph node metastatic tongue cancer cells by elevated signaling via the TNF-α-TNFR1-NF-κB pathway and a possible involvement of angiopoietin-like 4 in lung metastasis

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