Neck Management in cT1N0 Tongue Squamous Cell Carcinoma as Determined by Sonographic Depth of Invasion

Abstract

ObjectivesTo compare the oncologic outcomes in patients with cT1N0 tongue squamous cell carcinoma (SCC) who underwent different neck management strategies stratified by sonographic depth of invasion (DOI).MethodsThe included patients were retrospectively enrolled, and divided into two groups: observation (OBS) and elective neck dissection (END). The regional control (RC) and disease-specific survival (DSS) rates were compared and stratified by sonographic DOI.ResultsThe mean sonographic and pathologic DOIs were 3.8 and 3.7 mm, respectively; the two DOIs were significantly correlated (Spearman correlation coefficient 0.974. p <0.001). In patients with sonographic DOI <4.0 mm, the 5-year RC rates were 73 and 89% in the OBS and END groups, respectively, and were not significantly different. However, in patients with sonographic DOI ≥4.0 mm, the 5-year RC rate was significantly different between the OBS (57%) and END (80%) groups (p = 0.031). In patients with sonographic DOI <4.0 mm, the 5-year DSS rates were 79 and 89% in OBS and END groups, respectively, and were not significantly different. However, in patients with sonographic DOI ≥4.0 mm, the 5-year DSS rate was significantly different between the OBS (67%) and END (86%) groups (p = 0.033).ConclusionsSonographic DOI was notably correlated with pathologic DOI. Moreover, there was a significant survival difference between the OBS and END groups in cT1N0 tongue SCC patients with sonographic DOI ≥4.0 mm but not in those with sonographic DOI <4.0 mm. Our study provides a useful method to aid decision-making in the clinical setting for this patient group.

Neck management in cutaneous squamous cell carcinoma with parotid metastasis

“…The authors acknowledged the two apparently conflicted points tended to be attributed by their retrospective design, more importantly, the status of parotid LN was not evaluated, parotid LN was the first drainage site, its positivity highly predicted cervical metastasis, and patients with negative parotid disease were likely to be treated by observation, then a better OS developed. Current study confirmed observation was associated with worse RC and OS in P+ HNcSCC, even there was higher possibility of salvaged surgery in patients managed by observation, underlying mechanism might be that delay detected metastasis decreased the prognosis significantly 12 …”

“…Current study confirmed observation was associated with worse RC and OS in P+ HNcSCC, even there was higher possibility of salvaged surgery in patients managed by observation, underlying mechanism might be that delay detected metastasis decreased the prognosis significantly. 12 Active neck intervention offered better prognosis, and END was a good option. There exists a consensus that END is crucial for managing cN0 necks if the rate of occult metastasis is above 20% in oral squamous cell carcinoma.…”

Occult neck metastases risk factors and the role of elective neck dissection in cT3-4N0 adenoid cystic carcinoma of the parotid gland

“…The current study overcame these shortcomings and confirmed END was not associated with improved OS or DSS in cT3-4N0 parotid ACC, but there was an interesting finding that END provided better LRC and DMS. Removing positive lymph nodes and blocking the pathway of lymph node metastasis in time could decrease the risk of regional recurrence ( 26 ). Conversely, evidence of lymphatic spread increased the rate of distant metastases ( 4 , 13 ), and END improved DMS.…”