When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck? A systematic review

Liszen, Tang; Leung, Yiu Yan

doi:10.1016/j.ijom.2016.05.021

Cited by 15 publications

(12 citation statements)

References 36 publications

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“…Thirteen SRs15,16,18–27,29 included a meta-analysis, and all SRs15–29 were published in English between 2010 and 2018. Nine SRs15,19,22–26,28,29 had focused on oral cavity cancer exclusively, whereas other six SRs16–18,20,21,27 had focused on head and neck cancers, with the oropharyngeal cancer being the most frequent among them. Eight SRs15,17,19,22,24,27–29 assessed surgical interventions, three SRs16,21,25 assessed radiotherapy, three SRs20,23,26 assessed chemotherapy and one SR18 assessed targeted therapy and immunotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…Interventions reported as “beneficial” were as follows: 1) the elective neck dissection was better than no elective neck dissection in patients with negative neck nodes in terms of cervical metastasis rate, overall 5-year survival rate and occult cervical metastasis;28 2) the incontinuity neck dissection was better than discontinuous neck dissection in terms of local recurrence;29 3) a wider pathological margin (≥5 mm) was better than a narrow pathological margin (<5 mm) in terms of local recurrence rates in patients with oral squamous cell carcinoma treated by primary surgery without adjuvant therapy;15 4) radiotherapy combined with surgery was better than radiotherapy alone in terms of total mortality;17 5) the use of intra-arterial bleomycin and vincristine combined with surgery was better than surgery alone in terms of overall survival;20 6) post-surgery chemotherapy using methotrexate as chemotherapy drug was better than surgery alone in terms of total mortality;20 7) induction chemotherapy followed by surgery with or without radiotherapy was better than surgery with or without radiotherapy in patients with positive nodules classified as level II, in terms of overall survival26 and 8) the use of recombinant interleukin-2 plus surgery was better than surgery alone in terms of overall survival 18…”

Section: Resultsmentioning

confidence: 99%

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Evidence mapping and quality assessment of systematic reviews on therapeutic interventions for oral cancer

Anaya¹,

Franco²,

Ballesteros³

et al. 2018

CMAR

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Purpose: This evidence mapping aims to describe and assess the quality of available evidence in systematic reviews (SRs) on treatments for oral cancer. Materials and methods: We followed the methodology of Global Evidence Mapping. Searches in MEDLINE, EMBASE, Epistemonikos and The Cochrane Library were conducted to identify SRs on treatments for oral cancer. The methodological quality of SRs was assessed using the Assessing the Methodological Quality of Systematic Reviews-2 tool. We organized the results according to identified Population-Intervention-Comparison-Outcome (PICO) questions and presented the evidence mapping in tables and a bubble plot. Results: Fifteen SRs met the eligibility criteria, including 118 individual reports, of which 55.1% were randomized controlled clinical trials. Ten SRs scored "Critically low" methodological quality. We extracted 30 PICOs focusing on interventions such as surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy; 18 PICOs were for resectable oral cancer, of which 8 were reported as beneficial. There were 12 PICOs for unresectable oral cancer, of which only 2 interventions were reported as beneficial. Conclusion: There is limited available evidence on treatments for oral cancer. The methodological quality of most included SRs scored "Critically low". The main beneficial treatment reported by authors for patients with resectable oral cancer is surgery alone or in combination with radiotherapy or chemotherapy. Evidence about the benefits of the treatments for unresectable oral cancer is lacking. These findings highlight the need to address future research focused on new treatments and knowledge gaps in this field, and increased efforts are required to improve the methodology quality and reporting process of SRs on treatments for oral cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Evidence mapping and quality assessment of systematic reviews on therapeutic interventions for oral cancer

Anaya¹,

Franco²,

Ballesteros³

et al. 2018

CMAR

View full text Add to dashboard Cite

show abstract

“…However, an arithmetic proportion of 14.7% is not ignorable. Many authors have published that the overall OCM was 13.7% to 42.9% according to T1 stage in MSCC 2 3 4 . In a retrospective cohort study of 62 patients, Yang et al 3 showed that OCM of MSCC in tumor stages T2 to T4 occurred in 20% to 40% of patients, in whom END is recommended for management.…”

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confidence: 99%

“…From 2010 to 2016, many articles analyzed clinical outcomes and reviewed some meta-analyses based on the pathologic stage, including T classification and histopathologic differentiation, rather than successful locoregional management. From a systematic review, designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, Tang and Leung 4 emphasized that the overall risk of OCM was 23.2% in non-END, which was 3.4 times higher than that in the END group (6.8%). The five-year SR was higher in those who had an END (80.3%) compared to those who did not receive an END (67.4%).…”

mentioning

confidence: 99%

“…The risk of OCM in cN0 MSCC cases with pathological stage pT1, pT2, pT3, and pT4 was 11.1%, 12.1%, 20%, and 36.1%, respectively. Thus, the authors concluded that END is recommended in patients with cN0 MSCC, especially those in stage T3 or T4 case 4 . In a single center retrospective study with 86 cN0 MSCC patients, Poeschl et al 7 found that, with overall tumor stages combined (T1-T4), END did not significantly improve overall SR and did not prevent regional recurrence in cN0 MSCC patients.…”

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Importance of elective neck dissection in cN0 maxillary squamous cell carcinoma

Kwon

Kim

2018

J Korean Assoc Oral Maxillofac Surg

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Systematic review and meta‐analysis of cervical metastases in oral maxillary squamous cell carcinoma

et al. 2021

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Background: Management of the node-negative neck in oral maxillary squamous cell carcinoma (SCC), encompassing the hard palate and upper alveolar subsites of the oral cavity, is controversial, with no clear international consensus or recommendation regarding elective neck dissection in the absence of cervical metastases.Aim: To assess the occult metastatic rate in patients with clinically node negative oral maxillary SCC; both as an overall metastatic rate, and a comparison of patients managed with an elective neck dissection at index surgery, compared to excision of the primary with clinical observation of the neck. Methods and results:A systematic review was performed by two independent investigators for studies relating to oral maxillary SCC and analysed according to PRISMA criteria. Data were extracted from Pubmed, Ovid MEDLINE, EMBASE, and SCOPUS via relevant MeSH terms. Grey literature was searched through Google Scholar and OpenGrey. Five hundred and fifty-three articles were identified on the initial search, 483 unique articles underwent screening against eligibility criteria, and 29 studies were identified for final data extraction. Incidence of occult metastases in patients with clinically node negative oral maxillary SCC was identified either on primary elective neck dissection or on routine follow up. Meta-analyses were performed. Of 553 relevant articles identified on initial search, 29 were included for analysis. The pooled overall rate of occult metastases in patients initially presenting with clinically node-negative disease was 22.2%. There is a statistically significant effect of END on decreasing regional recurrence demonstrated in this study (RR 0.36, 95% CI 0.24, 0.59). Conclusion:The results of this systematic review and meta-analysis suggest elective neck dissection for patients presenting with hard palate or upper alveolar SCC, even in a clinically node negative neck.

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When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck? A systematic review

Cited by 15 publications

References 36 publications

Evidence mapping and quality assessment of systematic reviews on therapeutic interventions for oral cancer

Evidence mapping and quality assessment of systematic reviews on therapeutic interventions for oral cancer

Importance of elective neck dissection in cN0 maxillary squamous cell carcinoma

Systematic review and meta‐analysis of cervical metastases in oral maxillary squamous cell carcinoma

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