Is selective neck dissection effective for N1 (Level Ⅰ)? A systematic review

Abstract

ObjectiveThis systematic review and meta-analysis aimed to compare the effectiveness of selective neck dissection (SND) and comprehensive neck dissection (CND) in patients with oral squamous cell carcinoma N1 (Level I). MethodsRandomized controlled trials and prospective and retrospective non-randomized clinical studies were selected and evaluated for the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The statistical analysis was performed using Review Manager 5.4 software. ResultsWe included one observational study. The analysis revealed no difference in survival rates (overall survival, disease-specific survival, and regional control) between SND and CND for oral squamous cell carcinoma N1 (level I) cases. In the included study, the risk of bias was high, total sample size was small, and certainty of evidence was rated as "very low.". ConclusionThis systematic review and analysis suggested no difference in effectiveness between SND and CND; however, a high certainty of evidence could not be determined. Such evidence needs to be established through future systematic reviews, including randomized controlled trials with larger sample sizes.