Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma

Feng, Zhien; Gao, Yan; Niu, Li; Peng, Xin

doi:10.1016/j.ijom.2014.05.018

Cited by 19 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although lymph node metastasis is the most important prognostic factor for O/OPSCC, the precise risk stratification of pN + patients using traditional TNM stages is inadequate 16 . Based on the results from our previous studies, the traditional TNM stage might not be the best prognostic factor in the presence of ECS, adjuvant treatments and even some important biomarkers 17 , 18 . The LNR has recently been described as a potential predictor of survival and the need for adjuvant treatment in patients with O/OPSCC.…”

Section: Discussionmentioning

confidence: 99%

Lymph node ratio is associated with adverse clinicopathological features and is a crucial nodal parameter for oral and oropharyngeal cancer

Feng

Wang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

The lymph node ratio(LNR) has been described as a novel predictor of the survival of patients with oral and oropharyngeal squamous cell carcinoma(O/OPSCC). The purpose of this study was to evaluate whether LNR is better at predicting survival and the need for adjuvant treatment than traditional tumour-nodal-metastasis(TNM) staging. Eight hundred nine patients with O/OPSCC and positive lymph node disease were retrospectively enrolled in this study. LNR equal to 0.075 is the best cut-off value for stratifying 5-year disease-free survival(DFS). High LNR is closely associated with more advanced T stage, higher N stage, more severe pathological grade, the presence of diffuse infiltration and extracapsular spread(ECS). LNR is better for evaluating prognosis than the pathological N stage. Patients with high LNR coupled with high number of positive lymph nodes who received adjuvant concurrent chemo-radiotherapy(CCRT) had a better 5-year DFS than patients who received surgery alone. Multivariate analyses revealed that T stage, ECS and LNR are independent prognostic factors of 5-year DFS and disease-specific survival(DSS). Therefore, high LNR is closely correlated with adverse parameters that markedly hinder prognosis. LNR is superior to traditional TNM staging for the evaluation of prognosis,and the combination of the LNR with the number of positive lymph nodes can predict the benefits of adjuvant CCRT.

show abstract

Section: Discussionmentioning

confidence: 99%

Lymph node ratio is associated with adverse clinicopathological features and is a crucial nodal parameter for oral and oropharyngeal cancer

Feng

Wang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…11 A Cochrane analysis by Bessell et al found no evidence that RND increases overall survival compared to more conservative neck dissection surgery. 12 The main reasons for choosing SND over CND in cN0 neck are better and functional outcomes. In the study reported by Feng et al, the SND group showed significantly fewer complications and faster recovery compared with the MRND group (7.3% vs 20%).…”

Section: Discussionmentioning

confidence: 99%

Limited neck dissection: is it enough in early oral tongue cancer? Retrospective study

Shanmugam

Kishore

2019

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

Background: The objective of the present study was to analyze the outcome of clinically node-negative early oral tongue cancer after selective neck dissection (SND) versus conventional neck dissection (CND).Methods: A total of 116 patients of early oral tongue cancer underwent neck dissection either SND or CND between 1st January 2013 to 31st December 2016 at Government Royapettah Hospital, Chennai, a tertiary level cancer center. For patients with pN0 after SND had no further procedure while for those with cN1 disease, CND was done as a standard procedure. Comparison between the cN0 nodes to pN1 conversion rates in SND group with cN1 to pN0 rates in CND group was done along with the morbidity rates. The clinicopathological parameters along with intraoperative and postoperative parameter relevant to recurrence were analyzed by univariant and multivariant analysis and both the groups were compared by Chi-square test (SPSS version 26.0). Results: In the SND group, pN1 were 2/53 (3.77%) and in the CND group pN1 was 11/63 (17.46%). Mean Nodal retrieval in SND group was 18.96 nodes and in CND group 22.90 nodes per case. Regional nodal recurrences in the SND group were 8/53 (15.81%) and in the CND group was 9/63 (14.28%). Our study shows no significant statistical difference between nodal recurrences in CND and SND group.Conclusions: Our study data suggests that for cN1 patients, SND may be optimal and early tongue cancer patients with cN0 could be candidates for an SND instead of CND.

show abstract

“…Therefore, for the management of regional lymph nodes in OSCC, SND (I–III) has become the standard elective procedure for clinically node-negative (cN0) patients or those with microscopic disease [13,14]. With respect to the management of cN+ OSCC, some authors agree that SND (I–III) may be considered together with adequate removal of the gross tumor with or without adjuvant radiotherapy [15,16,17]. However, whether therapeutic SND (I–III) is appropriate for cN+ disease in the neck remains unclear because the objective measures for patient selection have not been clearly defined [17].…”

Section: Introductionmentioning

confidence: 99%

Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma

Shimura

Ogi

Miyazaki

et al. 2019

Cancers

View full text Add to dashboard Cite

The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p < 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p < 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated.

show abstract

Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma

Cited by 19 publications

References 18 publications

Lymph node ratio is associated with adverse clinicopathological features and is a crucial nodal parameter for oral and oropharyngeal cancer

Lymph node ratio is associated with adverse clinicopathological features and is a crucial nodal parameter for oral and oropharyngeal cancer

Limited neck dissection: is it enough in early oral tongue cancer? Retrospective study

Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma

Contact Info

Product

Resources

About