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; = .77; fixed-effects model), DSS (HR, 1.07; CI, 1.02-1.13; = .31; fixed-effects model), and DFS (HR, 0.86; CI, 0.72-1.01; = .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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6793606 | PMC |
| http://dx.doi.org/10.1002/lio2.301 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
"Robotic elective neck dissection in early-stage tongue cancer: A critical appraisal of oncologic and cosmetic outcomes".
Eur J Surg Oncol
December 2024
Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. Electronic address:
Adjuvant Intensity Modulated Radiation Therapy With a Pedicled Flap Reconstruction in Oral Cavity Squamous Cell Carcinomas: Implications on Target Delineation.
Head Neck
December 2024
Department of Head & Neck Surgery, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Objectives: To address controversies regarding target volume delineation for adjuvant intensity-modulated radiation therapy for oral cavity squamous cell carcinoma with pedicled flap reconstruction and elective nodal irradiation (ENI).
Materials And Methods: During target volume delineation, the primary tumor bed was the pre-surgical gross tumor volume with an additional isotropic margin of 5-10 mm. Additionally, the flap and body tissue junction were given a margin of 5-10 mm (if not already given).
A Case of Laparoscopic Transabdominal Pre-peritoneal Hernia Repair Using a 3D Mesh Inversion Technique for Bilateral Obturator and Femoral Hernias After Incarcerated Obturator Hernia Reduction.
Cureus
November 2024
Department of General Surgery, Juntendo University Nerima Hospital, Tokyo, JPN.
An obturator hernia (OH) is a rare type of hernia that accounts for a very small proportion of all hernias and cases of small bowel obstruction. This condition predominantly affects older, underweight individuals, with the vast majority of patients being women. Laparotomy with simple suture closure of the defect is commonly used as surgical treatment for OH.
View Article and Find Full Text PDFHostile Neck Index is a Novel and Strong Predictor of Type I Endoleak Development After Endovascular Aortic Repair for Abdominal Aortic Aneurysm.
Ann Vasc Surg
December 2024
Department of Cardiovascular Surgery, Bursa City Hospital, Bursa, Turkey. Electronic address:
Article Synopsis
- The study examined the risk factors for developing type I endoleak in patients undergoing elective endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA).
- A total of 105 patients were analyzed, dividing them into those who experienced endoleak (23) and those who did not (82), comparing demographic and clinical characteristics between the two groups.
- High hostile neck index (HNI) was identified as a significant independent predictor of type I endoleak, with a specific cut-off value determined for predicting endoleak risk.
Postoperative high-dose-rate brachytherapy alone in stage T1-3N0M0 oral cancer with negative prognostic factors: A retrospective study.
Brachytherapy
December 2024
Department of Oncology and Radiotherapy, University Hospital and Medical Faculty Hradec Kralove Hradec Kralove, Czech Republic.
Purpose: To evaluate treatment outcomes and toxicity in patients with stage T1-3N0M0 oral cancer treated with surgery followed by high-dose-rate brachytherapy (HDR-BT).
Methods And Materials: Retrospective study of 50 patients with stage T1-T3N0 tongue and floor-of-mouth cancer who underwent tumour excision (+ elective neck dissection) followed by postoperative HDR-BT due to the presence of negative prognostic factors (close or positive resection margins, lymphovascular and/or perineural invasion, deep invasion). The plastic tube technique (dose: 18 x 3 Gy b.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!