What is the role of elective neck dissection in patients with squamous cell carcinoma of the upper jaw?

Moreno-Sánchez, Manuel; González-García, Raúl; González-Ballester, David; Ruíz-Laza, Luis; Moreno-García, Carlos; Monje, Florencio

doi:10.1016/j.maxilo.2016.02.003

Cited by 6 publications

(12 citation statements)

References 19 publications

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“…In our series, we founded that 9 of the 20 (45%) patients with SCC involving the palate or the maxillary alveolus [ Figures 1 and 2] developed cervical metastases [ Figure 3] during disease. [42] In the 28 articles included in this systematic review, the initial nodal disease was 16% and cervical metastases rate ranged from 11% to 67% with an overall metastases rate of 33% in a total of 2,641 patients, which was similar to the cervical metastases from SCC of other oral sites, such as the tongue or floor of the mouth.…”

Section: Discussionmentioning

confidence: 76%

“…Wang et al [36] Taiwan 79 Retrospective 100% 9% 22% Unknown Valentini et al [25] Italy 19 Retrospective Unknown 5% 11% Unknown Beltramini et al [26] Italy 65 Retrospective 86% 12% 22% 43.3 Morris et al [15] USA 139 Retrospective 71% 8% 31% 57 Brown et al [10] UK 43 Retrospective 81% 7% 37% 94 Poeschl et al [33] Austria 74 Retrospective 100% Unknown 22% 6-130 Dalal and McLennan [30] UK 30 Retrospective 100% 27% 36% 60 Feng et al [27] China 129 Retrospective 65% 0% 24% Unknown Eskander et al [32] Canada 97 Cohort 53% 24% 41% Unknown Sagheb et al [29] Germany 138 Retrospective 60% 38% 46% 43 Zhang et al [37] China 100 Retrospective 79% 9% 34% 46 Philip et al [24] UK 39 Retrospective 95% 33% 46% 38 Givi et al [39] USA 199 Retrospective 50% 6% 22% 52 Berger et al [40] Germany 171 Retrospective 78% Unknown 44% Unknown Yang et al [28] China 62 Retrospective 69% 15% 37% 37 Troeltzsch et al [41] Germany 92 Retrospective 40% 16% 29% 42 Moreno-Sánchez et al [42] Spain 20 Retrospective 100% 30% 45% 53…”

Section: Methodsmentioning

confidence: 99%

“…However, in recent studies, [31][32][33][34][35] it has been proven that a higher rate of occult cervical metastases in SCC of the maxilla has been found [36][37][38][39][40] and elective neck dissection in these patients has been recommended in order to reduce recurrences. [41][42][43] A systematic review was conducted in order to clarify if elective neck dissection is necessary in management of SCC of the maxillary gingiva, maxillary alveolus and hard palate, and to identify the risk of cervical metastases in patients with maxillary SCC.…”

Section: Introductionmentioning

confidence: 99%

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Elective neck dissection in oral squamous cell carcinoma of the upper maxilla: necessary?

Moreno-Sánchez¹

2016

PAR

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Aim: Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma (SCC) of the upper jaw is controversial. The purpose of this systematic review was to define the incidence of cervical metastasis and to assess if elective neck dissection is justified when the neck is not primarily affected. Methods: An electronic literature search was conducted in several databases, including MEDLINE, EMBASE, and Cochrane Central databases, for articles written in English. Results: Twenty-eight articles were included in the review. The overall cervical metastases rate was 33% and the total initial cervical metastases rate was 16%. Interestingly, the author found that 71% of patients with cervical metastases from maxillary SCC carcinoma were T3/T4 stage. Conclusion: This review shows the need for a change in the management of the N0 neck in SCC arising in the maxillary alveolus and hard palate. Elective neck dissection should be performed in patients with T3/T4 tumours with clinic or radiographic negative necks (N0c).

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Section: Discussionmentioning

confidence: 76%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Elective neck dissection in oral squamous cell carcinoma of the upper maxilla: necessary?

Moreno-Sánchez¹

2016

PAR

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“…In Meng et al's series of 78 patients, they noted that although rates of positive nodal metastasis from T1 T2 tumors were lower than 15%; those from higher stage tumors were greater than 40%. In a retrospective series of 20 patients, Moreno‐Sanchez et al showed that cervical metastasis was only present in pT3T4 tumors of the maxillary alveolus and hard palate. This may explain the relatively lower occult metastatic rate seen in our review, given 27.1% of END performed were for T2 disease and may have lowered the occult positive rate.…”

Section: Discussionmentioning

confidence: 99%

Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival

Obayemi

Cracchiolo

Migliacci

et al. 2019

Journal of Surgical Oncology

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Background and Objectives: The reported risk of nodal metastasis in hard palate and upper gingival squamous cell carcinoma (SCC) has been inconsistent with inadequate consensus regarding the utility of neck dissection in the clinically negative (cN0) neck. Materials and Methods: Using the National Cancer Database, cN0 patients diagnosed with SCC of the head and neck with the subsites of the hard palate and upper gingiva were identified from 2004 to 2014. Results: A total of 1830 patients were identified, and END was performed on 422 patients with cN0 tumors. Pathologically positive nodes occurred in 14% (59/422) of patients in this cohort. Higher tumor stage, academic hospital type, and large hospital volume (>28 cancer-specific cases/year) were associated with a higher likelihood of END both in univariate and multivariate analyses (P < .05). Patients >80 years of age were less likely to receive END on multivariate analysis (OR 0.52, 0.32-0.84). No variables, including advanced T stage, predicted occult metastases. Cox proportional hazards regression analysis showed that patients who underwent END demonstrated improved OS over an 11-year period (hazard ratio 0.75, P = .002). On subgroup analysis, this improvement was significant in patients with both stage T1 and T4 tumors.Conclusions: Tumor stage, hospital type, and hospital volume were associated with higher rates of END for patients with cN0 hard palate SCC and after controlling for clinical factors, END was associated with improved overall survival. K E Y W O R D S carcinoma squamous cell head and neck, gingiva, hard palate, logistic models, neck dissection, prevalence How to cite this article: Obayemi A Jr, Cracchiolo JR, Migliacci JC, et al. Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival.

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“…It reduces the trauma of surgical intervention, provides reliable hemostasis, creates sterility in the wound, reduces pain and swelling in the postoperative period, shortens the regeneration period of the tissues and forms soft elastic scars in comparison with excision with a scalpel. The diode laser is used to perform various operations [11][12][13]. In [14], researchers developed a nanosecond diode laser, which allows the removal of epulides.…”

Section: Introductionmentioning

confidence: 99%

Cutting velocity accuracy as a criterion for comparing robot trajectories and manual movements for medical industry

Vorotnikov

Klimov

Romash

et al. 2017

Mechanics & Industry

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Abstract. Industrial robots perform technological operations, such as spot and arc welding, machining and laser cutting along different trajectories within their performance characteristics. The evaluation of these characteristics is carried out according to the criteria of the standard ISO 9283. The criteria of this standard are applicable in industrial manufacturing, but not in the medical industry, as they are not developed in the framework of medical tasks. Therefore, it is necessary to evaluate according to criteria built on different principles. In this article, the question of comparative evaluation of trajectories from program movements of a robot and manual movements of a surgeon, arising during the development of robotic medical complexes using industrial robots, is considered. A comparative evaluation is required to prove the expediency of automating medical operations in maxillofacial surgery. This study focuses on the estimation of velocity accuracy of a medical instrument. To obtain the velocity of the medical instrument, coordinates of the trajectory points from the program movements of the robot KUKA LWR4+ and trajectories from the manual movements of a professional surgeon have been measured. The measurement was carried out using a coordinate measuring machine, the laser tracker Leica LTD800. The accuracy estimation was carried out by two criteria: the criterion set out in the ISO 9283 standard, and the developed alternative criterion, the description of which is presented in this article. A quantitative comparative evaluation of the trajectories of a robot and a surgeon was obtained.

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What is the role of elective neck dissection in patients with squamous cell carcinoma of the upper jaw?

Cited by 6 publications

References 19 publications

Elective neck dissection in oral squamous cell carcinoma of the upper maxilla: necessary?

Elective neck dissection in oral squamous cell carcinoma of the upper maxilla: necessary?

Elective neck dissection (END) and cN0 hard palate and upper gingival cancers: A National Cancer Database analysis of factors predictive of END and impact on survival

Cutting velocity accuracy as a criterion for comparing robot trajectories and manual movements for medical industry

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