The Danish national guidelines for treatment of oral squamous cell carcinoma

Bilde, Anders; Buchwald, Christian von; Johansen, Jørgen; Bastholt, Lars; Sørensen, Jens Ahm; Marker, Peter; Krogdahl, Annelise; Hansen, Hanne Sand; Specht, Lena; Kirkegaard, Jørgen; Andersen, Elo; Bentzen, Jens; Hjort-Sørensen, Christian; Andersen, Lisbeth Juhler; Nielsen, B; Bundgaard, Troels; Overgaard, Marie; Grau, Cai

doi:10.1080/02841860600592998

Cited by 28 publications

(37 citation statements)

References 30 publications

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“…The treatment of OSCC follows the national guidelines produced by the Danish Society of Head and Neck Oncology [3]. SNB was performed in all patients by the head and neck surgeons (C.B., J.K. or B.C.)…”

Section: Surgerymentioning

confidence: 99%

“…The treatment for OSCC stage I and II (T1-2N0M0) according to the UICC TNM classification is radical excision of the primary tumor and a selective neck dissection covering level IÁIII and for anterior tongue level I ÁIV including removal of the submandibular gland [3]. This treatment exposes the majority of patients with a clinically N0 neck to an unnecessary morbidity of a neck dissection in case of a pathologically N0 neck.…”

Section: Introductionmentioning

confidence: 99%

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The role of SPECT-CT in the lymphoscintigraphic identification of sentinel nodes in patients with oral cancer

Bilde¹,

Buchwald²,

Mortensen³

et al. 2006

Acta Oto-Laryngologica

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SNB was conducted in 33 patients. SNs were identified in 94% (32/34) of the patients using SPECT-CT. In 91% (29/32) of the patients SNs were harvested from all of the levels involved on SPECT-CT. SPECT-CT imaging demonstrated extra SNs compared with planar lymphoscintigraphic imaging in 47% (15/32) of patients. In seven cases the anatomical level of SN according to SPECT-CT was reclassified during surgery. The overall incidence of lymph node metastases was 19% (6/32). There were no false negative SNs.

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Section: Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of SPECT-CT in the lymphoscintigraphic identification of sentinel nodes in patients with oral cancer

Bilde¹,

Buchwald²,

Mortensen³

et al. 2006

Acta Oto-Laryngologica

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“…Up to 30% of OSCC patients with a clinical N0 (cN0) neck can be demonstrated to harbor occult lymph node metastases when performing a sentinel lymph node biopsy (SNB). The discovery of a single micro- or macroscopic lymph node metastasis confers a poorer prognosis [3, 4]. Identifying which patients with early-stage OSCC who have a high risk of harboring occult lymph metastases is of great clinical importance, since these patients would benefit from therapeutic neck dissection [5].…”

Section: Introductionmentioning

confidence: 99%

Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma

et al. 2017

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It is challenging to identify at diagnosis those patients with early oral squamous cell carcinoma (OSCC), who have a poor prognosis and those that have a high risk of harboring occult lymph node metastases. The aim of this study was to develop a standardized and objective digital scoring method to evaluate the predictive value of tumor budding. We developed a semi-automated image-analysis algorithm, Digital Tumor Bud Count (DTBC), to evaluate tumor budding. The algorithm was tested in 222 consecutive patients with early-stage OSCC and major endpoints were overall (OS) and progression free survival (PFS). We subsequently constructed and cross-validated a binary logistic regression model and evaluated its clinical utility by decision curve analysis. A high DTBC was an independent predictor of both poor OS and PFS in a multivariate Cox regression model. The logistic regression model was able to identify patients with occult lymph node metastases with an area under the curve (AUC) of 0.83 (95% CI: 0.78–0.89, P <0.001) and a 10-fold cross-validated AUC of 0.79. Compared to other known histopathological risk factors, the DTBC had a higher diagnostic accuracy. The proposed, novel risk model could be used as a guide to identify patients who would benefit from an up-front neck dissection.

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“…Mean age of the patients at the time of the operation was 59.4 years, range 22-92 years and 61% were males. In 95 patients with oral cancer neck dissection was performed in level I B as well as in other levels of the neck according to our national recommendations for treatment of oral cancer [18]. No patients had been operated on before in the neck but 15 patients (15.8%) had previously been treated with radiotherapy.…”

Section: Methodsmentioning

confidence: 99%

Risk of marginal mandibular nerve injury in neck dissection

Möller

Sørensen

2011

Eur Arch Otorhinolaryngol

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The immediate and permanent frequency of injury to the marginal mandibular branch of the facial nerve (MMN) after neck dissection has only scarcely been addressed in the medical literature. We investigated the risk of injury in 159 consecutive patients after neck dissection for various reasons in level I B and level II A, respectively. In 95 patients with oral cancer 13 (14%) of the cases had malfunction of the lower lip domain 2 weeks after neck dissection in level I B indicating paresis to the MMN. Follow-up analyses 1-2 years after the operation showed permanent paralysis in 4 to 7% of the cases in whom two of them had the nerve sacrificed for oncologic reasons during the operation. In 18 patients with parotic cancer the corresponding permanent frequency of MMN paralysis was 11.1%. In 46 patients with neck dissection in level II A but not in level I B, no paresis of the MMN was registered. Recognition of the MMN during the operation, pre- or postoperative radiation therapy, re-operation for deep hemorrhage, age, gender or postoperative infection did not have any statistically significant influence on the frequency of MMN injury. In conclusion we found a moderate risk of injury to the MMN after neck dissection in level I B whereas the corresponding risk after level II A dissection was negligible.

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The Danish national guidelines for treatment of oral squamous cell carcinoma

Cited by 28 publications

References 30 publications

The role of SPECT-CT in the lymphoscintigraphic identification of sentinel nodes in patients with oral cancer

The role of SPECT-CT in the lymphoscintigraphic identification of sentinel nodes in patients with oral cancer

Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma

Risk of marginal mandibular nerve injury in neck dissection

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