Abstract
The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p < 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p < 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated.
Highlights
Oral squamous cell carcinoma (OSCC) constitutes a broad range of tumors with diverse etiologies that are classified by region
Confirmed that only selective neck dissection (SND) (I–III) with (4 patients) or without (31 patients) adjuvant radiotherapy for oral squamous cell carcinoma (OSCC) with pN+ that were limited to levels I and II was appropriate for patients with up to 2 tumor-positive lymph nodes with a largest tumor diameter of ≤3 cm rather than the immunohistochemical invasive tumor patterns or density of tumor–infiltrating CD8+ T cells
Patients treated with SND (I, I–III or I–IV) that was followed by adjuvant therapy had comparable clinical outcomes to modified radical neck dissection (MRND)/radical neck dissection (RND) because no significant difference was found for regional recurrence, overall survival (OS) or disease-specific survival (DSS) between any of the dissection treatment types
Summary
Oral squamous cell carcinoma (OSCC) constitutes a broad range of tumors with diverse etiologies that are classified by region. The estimated age-standardized rate is relatively large at 2.7 per 100,000. This rate is 3.7 among men and 1.8 among women, with an estimated 202,000 patients newly diagnosed with oral cancer in 2012 [1]. It is widely accepted that OSCC metastasizes, which usually occurs through the lymphatic system to the cervical lymph nodes, with the most important prognostic factor being the presence of neck metastasis [2,3,4,5]. Some authors have shown that the failure pattern among OSCC patients is approximately 30%, which is typically due to regional metastases [6,7]. Pathologically proven lymph node metastases (pN+) are recognized as an adverse prognostic factor in OSCC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
