Risk of Contralateral Nodal Failure in Well Lateralized Early T-stage Oral Cavity Cancer Receiving Unilateral Treatment

Pattern of locoregional failure in postoperative cases of locally advanced carcinoma of buccal mucosa treated with unilateral versus bilateral neck radiation: lesson learned from a basic practice setup

“…Studies irradiating only the ipsilateral neck in carcinoma oral cavity have reported a contralateral neck nodal failure of 3.4–6% [ 10 , 16 , 17 ]. Among them, Rath et al had 100% of carcinoma buccal mucosa, and Vergeer et al had 62% cases with buccal mucosa primary [ 10 , 17 ].…”

“…3-year contralateral neck failure was 15.7%, with positive nodal metastasis and PNI being a significant risk factor for contralateral failure. For early-stage well lateralized oral cavity carcinoma treated with ipsilateral neck radiation, Liu et al reported no significant risk factors for contralateral nodal metastasis [ 16 ]. Our study did not report any contralateral nodal metastasis; thus, risk factors could not be identified.…”

Patterns of failure and clinical outcomes of post-operative buccal mucosa cancers treated with adjuvant ipsilateral radiotherapy

“…Several authors have previously reported on unilateral radiation therapy in well-lateralized oral cavity and oropharyngeal cancers [10,13,18,25] with excellent outcomes in terms of survival and contralateral neck control, but limited reports have been published addressing outcomes in cases of buccal cancers treated with unilateral irradiation. Publications by Vergeer et al [13] and Cerezo et al 18] have reported 5-year OS rates of 61% and 82.5%, respectively, in a combined cohort of oral cavity and oropharyngeal malignancies.…”

“…For patients with clear margins and no extracapsular extension, elective contralateral neck radiation is suggested for cases with high risk like advanced disease approaching midline and multiple positive nodes in the ipsilateral neck which increase the risk of nodal recurrence in the contralateral neck [9]. However, contralateral neck irradiation is not routinely performed [9][10][11]. Various clinical studies opine that ipsilateral neck dissection results in good outcomes with very limited contralateral neck failure in buccal mucosa cancers [12,13] setting the pretext for ipsilateral adjuvant radiotherapy in selected subset of buccal mucosa cancers.…”