Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma
| Autor: | Shunichi Shimura, Jun-ichi Kobayashi, Takeshi Kaneko, Tadashi Hasegawa, Shota Shimizu, Tomohiro Igarashi, Kazuhiro Ogi, Akihiro Miyazaki, Hiroyoshi Hiratsuka, Tomoko Sonoda, Akira Miyakawa |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment metastatic nodal parameters selective neck dissection lcsh:RC254-282 survival Article Metastasis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine Pathological business.industry Hazard ratio Neck dissection Retrospective cohort study lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens pathologically positive nodes medicine.disease Selective neck dissection Confidence interval oral squamous cell carcinoma stomatognathic diseases 030220 oncology & carcinogenesis Lymph business |
| Zdroj: | Cancers Cancers, Vol 11, Iss 2, p 269 (2019) Volume 11 Issue 2 |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers11020269 |
| Popis: | 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&ndash 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&ndash 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&ndash 16.72, p < 0.01 DSS, HR = 6.44, 95% CI: 1.76&ndash 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 &le 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. |
| Databáze: | OpenAIRE |
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