The role of elective neck dissection in early stage buccal cancer

Huang, Shiang‐Fu; Chang, Joseph Tung-Chieh; Liao, Chun‐Ta; Kang, Chung‐Jan; Lin, Chien‐Yu; Fan, Kang‐Hsing; Wang, Hung‐Ming; Chen, I-How

doi:10.1002/lary.24840

Cited by 34 publications

(35 citation statements)

References 28 publications

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“…Thirty‐nine studies assessed occult nodal metastasis in patients with cN0 T1 and T2 of oral SCC who underwent END (Table ), with five RCTs and 34 retrospective studies. The rate of occult metastasis in patients with cN0 ranged from 20.6% to 49% in the RCTs, and 7.3% to 39.2% in the retrospective series.…”

Section: Resultsmentioning

confidence: 99%

Management of N0 neck in early oral squamous cell carcinoma: A systematic review and meta‐analysis

et al. 2018

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Objective The role of elective neck dissection (END) in patients with stage I (T1N0) and II (T2N0) squamous cell carcinoma of the oral cavity remains a controversial topic. We investigate the need for END by establishing a true incidence of occult nodal disease as a function of T stage Data Sources MEDLINE, Google Scholar, Scopus. Review Methods Studies were selected using a set of inclusion and exclusion criteria. Meta‐analysis using a random‐effects model was employed to generate an odds ratio (OR) comparing the incidence of occult metastasis between T1 and T2 tumors, as well as regional recurrence rates between patients receiving END versus observation. Results Thirty‐nine publications comprising five randomized controlled trials and 34 retrospective studies were selected for inclusion, yielding over 4,300 patients for analysis. The overall incidence of occult nodal metastasis, weighted by study size, was found to be 23%. Patients with T2 tumors have a significantly higher odds of having occult nodal disease (OR: 2.6, 95% confidence interval [CI]: 2.0‐3.4) over patients with T1 tumors. We also demonstrate that for patients who are observed, the odds of recurrence are significantly higher (OR: 4.18, 95% CI: 2.78‐6.28) compared to those who undergo END, although statistically significant interstudy heterogeneity was observed. Conclusions END should be reserved for stage II tumors given the significantly higher rate of occult metastasis. Observation may be more appropriate for stage I cancers. Laryngoscope, 129:E284–E298, 2019

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Section: Resultsmentioning

confidence: 99%

Management of N0 neck in early oral squamous cell carcinoma: A systematic review and meta‐analysis

et al. 2018

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“…[2][3][4][5][6][7][8][9][10][11][12][13] Overall incidence of occult nodal disease in cT1N0 oral cavity SCC is 15.1%, with the lowest risk (5.9%) in welldifferentiated tumors. To a lesser degree, there may be a link between female sex and occult disease, although, relative to tumor differentiation, the strength of association with these 2 variables was not as strong.…”

Section: Discussionmentioning

confidence: 99%

“…2 Recent prospective evidence from D'Cruz et al 3 on cT1-2N0 oral cavity SCC demonstrated significantly improved survival with up-front elective neck dissection (END) versus observation and therapeutic neck dissection for cT2N0 oral cavity SCC. [2][3][4][5][6][7][8][9][10][11][12][13] Currently, no large studies of occult nodal disease in cT1N0 oral cavity SCC exist. However, this survival benefit was equivocal in their cT1N0 cohort (44.2% of their study), accentuating the importance of reserving END for those The National Cancer Data Base (NCDB) is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society.…”

Section: Introductionmentioning

confidence: 99%

Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases

et al. 2018

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“…Although these primary tumors may be well controlled by surgical resection, a neck dissection is necessary when there is evidence of lymph node metastasis [5, 6]. However, there are no cancer cells in the cervical lymphatic tissues in some patients.…”

Section: Introductionmentioning

confidence: 99%

MFAP5 and TNNC1: Potential markers for predicting occult cervical lymphatic metastasis and prognosis in early stage tongue cancer

Yang

et al. 2016

Oncotarget

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The purpose of this study is to identify candidate genes that could predict prognosis of early-stage tongue squamous cell carcinoma (TSCC) and its occult cervical lymphatic metastasis by large-scale gene expression profiling. Tumor tissue and matched normal mucosa samples were collected from patients with TSCC and analyzed with Affymetrix HTA2.0 high-density oligonucleotide array. Differentially expressed genes in TSCC with cervical lymph node metastasis (CLNM) were further analyzed with Gene Ontology and Kyoto Encyclopedia of Genes and Genomes for their functions and related pathways. A total of 107 differentially expressed genes (p < 0.05) were identified by microarray in TSCC samples with CLNM (n = 6) compared to those without CLNM (n = 6). Genes involved in the cell-matrix adherens junction and migration function including MFAP5, TNNC1, MGP, FBFBP1 and FBXO32 were selected and validated by RT-PCR in TSCC samples (n = 32). Of the five genes, MFAP5 and TNCC1 expressions were further validated by immohistochemistry (n = 61). The significant positive correlation between MFAP5 and TNNC1 expression (p<0.001) was observed. Notably, over-expression of MFAP5 and TNNC1 were correlated with CLNM, metastasis relapse-free survival and overall survival. Our findings indicated that MFAP5 and TNNC1 may be potential markers for predicting occult cervical lymphatic metastasis and prognosis of oral tongue carcinoma.

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The role of elective neck dissection in early stage buccal cancer

Abstract: END was suggested in T1-T2N0 buccal cancer to improve the neck control rate. In patients for whom END is not performed at the time of tumor excision, regular follow-up of neck status is necessary because the metastatic lesions are mostly salvageable and do not influence the OS.

Cited by 34 publications

References 28 publications

Management of N0 neck in early oral squamous cell carcinoma: A systematic review and meta‐analysis

Management of N0 neck in early oral squamous cell carcinoma: A systematic review and meta‐analysis

Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases

MFAP5 and TNNC1: Potential markers for predicting occult cervical lymphatic metastasis and prognosis in early stage tongue cancer

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