Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients

Liu, Xiangqi; Lao, Xiaomei; Liang, Liyang; Zhang, Sien; Li, Kan; Liao, Guiqing; Liang, Yujie

doi:10.21147/j.issn.1000-9604.2017.03.03

Cited by 13 publications

(21 citation statements)

References 28 publications

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“…Our meta‐analysis of two studies revealed similar OS in both groups (HR, 1.08; CI, 0.68–1.49; P = .57) (Fig. S9).…”

Section: Meta‐analyses For the End Group With Oms Versus The Obs Groumentioning

confidence: 63%

“…Figure illustrates the study selection criteria and relevant reasons for exclusion. Finally, 15 studies including 3,158 patients were analyzed, comprising 1,726 patients undergoing END and 1,432 under OBS (Tables and ) …”

Section: Resultsmentioning

confidence: 99%

“…Our meta‐analyses of 9 studies and 14 studies revealed lower overall recurrence and lower neck recurrence, respectively, in patients undergoing END than in patients under OBS ([HR, 1.60; CI, 1.11–2.09; P = .03; Fig. S7] and [HR, 2.23; CI, 1.64–2.83; P = .0026; Fig.…”

Section: Meta‐analysis For End Versus Obsmentioning

confidence: 86%

“…In terms of DSS, our meta‐analyses of two studies revealed a nonsignificant difference between END and OBS in both patients with T1 primary oral cancer (HR, 0.94; CI, 0.84–1.05; P = .27; Fig. S12) and patients with T2 primary oral cancer (HR, 0.85; CI, 0.41–1.28; P = .50; Fig.…”

Section: Meta‐analyses For the End Group Versus The Obs Group With T1mentioning

confidence: 87%

“…Proponents of OBS suggest that OBS can yield 5‐year overall survival (OS) and disease‐specific survival (DSS) rates similar to those of END if patients adhere to close follow‐up with ultrasonography (i.e., once every 1–3 months during the first 3 years), CT or MRI every 6 months and undergo therapeutic (salvage) neck dissection whenever a cervical nodal metastasis is found . These proponents have found that 55%–90% patients do not require END, a procedure that increases operative mortality and morbidity and does not improve survival .…”

Section: Introductionmentioning

confidence: 99%

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Elective Neck Dissection Versus Observation in Early‐Stage (cT1/T2N0) Oral Squamous Cell Carcinoma

Liu

Chen

Bai

2019

Laryngoscope Investig Oto

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Objectives Whether to perform elective neck dissection (END) or apply the observation (OBS) policy in patients with early‐stage oral squamous cell carcinoma (OSCC) without clinical evidence of cervical lymph node metastasis (cT1/T2N0) remains uncertain. The two most recent meta‐analyses include many studies published before the widespread availability of CT scanning in the 1990s. With the rapid advancement in imaging studies since 1990, the early clinical detection of cervical node metastasis has become more reliable without the need for END or pathological staging. Thus, we conducted a systematic review and meta‐analysis of studies comparing survival outcomes between END and OBS in patients with cT1/T2N0 OSCC. Methods We performed a systematic search of MEDLINE, PubMed, and Scopus for retrospective and prospective studies published between January 1, 1990, and January 1, 2018, comparing clinical outcomes between END and OBS in patients with cT1/T2N0 OSCC. Information on population characteristics, study design, overall survival (OS), disease‐specific survival (DSS), and disease‐free survival (DFS) was extracted and estimated. Effect measures for outcomes were hazard ratios (HRs) and 95% confidence intervals (CIs). Results Thirteen retrospective and two prospective randomized studies (3,158 patients) met the inclusion criteria. Compared to OBS, END failed to significantly improve OS (HR, 1.02; 95% CI, 0.95–1.09; P = .77; fixed‐effects model), DSS (HR, 1.07; CI, 1.02–1.13; P = .31; fixed‐effects model), and DFS (HR, 0.86; CI, 0.72–1.01; P = .12; random‐effects model). Conclusions Our findings indicate that in patients with cT1T2N0 OSCC, the OBS policy can yield markedly similar OS, DSS, and DFS to those resulting from END. Level of Evidence 2

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“…Our meta‐analysis of two studies revealed similar OS in both groups (HR, 1.08; CI, 0.68–1.49; P = .57) (Fig. S9).…”

Section: Meta‐analyses For the End Group With Oms Versus The Obs Groumentioning

confidence: 63%

Section: Resultsmentioning

confidence: 99%

Section: Meta‐analysis For End Versus Obsmentioning

confidence: 86%

Section: Meta‐analyses For the End Group Versus The Obs Group With T1mentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Elective Neck Dissection Versus Observation in Early‐Stage (cT1/T2N0) Oral Squamous Cell Carcinoma

Liu

Chen

Bai

2019

Laryngoscope Investig Oto

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A robust and interpretable gene signature for predicting the lymph node status of primary T1/T2 oral cavity squamous cell carcinoma

Ghantous

Omar

Broner

et al. 2021

Intl Journal of Cancer

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Oral cavity squamous cell carcinoma (OSCC) affects more than 30 000 individuals in the United States annually, with smoking and alcohol consumption being the main risk factors. Management of early-stage tumors usually includes surgical resection followed by postoperative radiotherapy in certain cases. The cervical lymph nodes (LNs) are the most common site for local metastasis, and elective neck dissection is usually performed if the primary tumor thickness is greater than 3.5 mm. However, postoperative histological examination often reveals that many patients with early-stage disease are negative for neck nodal metastasis, posing a pressing need for improved risk stratification to either avoid overtreatment or prevent the disease progression. To this end, we aimed to identify a primary tumor gene signature that can accurately predict cervical LN metastasis in patients with early-stage OSCC.Using gene expression profiles from 189 samples, we trained K-top scoring pairs models and identified six gene pairs that can distinguish primary tumors with nodal metastasis from those without metastasis. The signature was further validated on an independent cohort of 35 patients using real-time polymerase chain reaction (PCR) in which it achieved an area under the receiver operating characteristic (ROC) curve and accuracy of 90% and 91%, respectively. These results indicate that such signature holds promise as a quick and cost effective method for detecting patients at high risk

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Elective neck dissection in T1/T2 oral squamous cell carcinoma with N0 neck: essential or not? A systematic review and meta-analysis

Ibrahim

Ahmed

Elsersy

et al. 2020

Eur Arch Otorhinolaryngol

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Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients

Cited by 13 publications

References 28 publications

Elective Neck Dissection Versus Observation in Early‐Stage (cT1/T2N0) Oral Squamous Cell Carcinoma

Elective Neck Dissection Versus Observation in Early‐Stage (cT1/T2N0) Oral Squamous Cell Carcinoma

A robust and interpretable gene signature for predicting the lymph node status of primary T1/T2 oral cavity squamous cell carcinoma

Elective neck dissection in T1/T2 oral squamous cell carcinoma with N0 neck: essential or not? A systematic review and meta-analysis

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