Abstract
BackgroundOur goal was to clarify the comparison between elective neck dissection (END) and the wait-and-see policy in neck management for cT1N0 buccal squamous cell carcinoma (SCC).MethodsThis was a retrospective comparison of 175 prospectively enrolled patients with cT1N0 buccal SCC. The patients were divided into two groups based on the nonrandomized management of the neck: 125 patients received END, and 50 patients were exposed to the wait-and-see policy. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS). Patients were asked to complete the shoulder domain in the University of Washington quality of life questionnaire, version 4, 1 year postoperatively.ResultsTen of the patients undergoing END developed recurrence, and the 5-year LRC rate was 92%. Five patients undergoing the wait-and-see policy developed recurrence, and the 5-year LRC rate was 90%. The difference was not significant (p = 0.668). There were 6 deaths in patients undergoing END, and the 5-year DSS rate was 94%. There were 3 deaths in patients undergoing the wait-and-see policy, and the 5-year DSS rate was 94%; the difference was not significant (p = 0.777). The mean shoulder scores of patients undergoing END and the wait-and-see policy were 93.9 and 100, respectively, and the difference was not significant (p = 0.284).ConclusionElective neck dissection does not carry a survival benefit compared to the wait-and-see policy, and it is not suggested for patients with cT1N0 buccal SCC.
Highlights
Our goal was to clarify the comparison between elective neck dissection (END) and the wait-and-see policy in neck management for cT1N0 buccal squamous cell carcinoma (SCC)
Neck lymph node metastasis is one of the most important prognostic factors in head and neck squamous cell carcinoma (SCC) [1,2,3], and early detection of neck lymph node disease is important for achieving better survival
Researchers who support routine neck dissection believe that elective neck dissection (END) is able to identify patients who need adjuvant treatment and provide better survival, but a number of scholars insist that there is a great deal of overtreatment in patients without pathologic neck lymph node metastasis based on the relatively low metastasis rate of cT1N0 buccal SCC
Summary
Our goal was to clarify the comparison between elective neck dissection (END) and the wait-and-see policy in neck management for cT1N0 buccal squamous cell carcinoma (SCC). Neck lymph node metastasis is one of the most important prognostic factors in head and neck squamous cell carcinoma (SCC) [1,2,3], and early detection of neck lymph node disease is important for achieving better survival. Owing to the wide range of occult. Fang et al BMC Cancer (2020) 20:537 between END and the wait-and-see policy in neck management for cT1N0 buccal SCC by a prospective study
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