Elective Neck Management in Node Negative Oral Cavity Cancer : Observation, Surgery, Radiation, surgery and radiation
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Abstract
Background: For the treatment of clinically node negative early-stage oral cavity squamous cell carcinoma (cN0-OSCC), there are several elective neck managements to preventing recurrence of the neck disease. Each pattern has a different effect on recurrence and survival rates. Furthermore, the results of previous studies have not been able to find a statistically significant difference clearly.
Methods: This is an analytical retrospective cohort in oral cancer patients. Surgical treatment of primary tumor is performed, and there are four methods of elective neck management: 1) observation (OBS), 2) elective neck dissection (END), 3) elective neck radiation (ENI), 4). Combined elective neck dissection and radiation therapy (END+RT). Data were collected between January 1st., 2015 to January 1st., 2020 and followed up for one year until January 1st., 2021. The outcome measures in this study were conducted using Kaplan-Meier to determine the disease-free survival and overall survival.
Results: A total of 124 cN0-OSCC participants met the inclusion criteria. All patients were divided into four groups: OBS (n=96) , END (n=15), ENI (n=9) and END+RT (n=4). The results showed that disease-free survival in the OBS, END, ENI, and END+RT groups were similar and not statistically significant (p=0.235), but overall survival of both OBS and END groups were significantly better compared to the ENI and END+RT groups (p<0.001).
Conclusion: The data from this study concluded that each elective neck management were not be different in disease-free survival, but the OBS and END methods had significantly better overall survival.
Keywords: Clinically node negative early stage oral cavity cancer (cN0-OSCC), elective neck management, elective neck irradiation, disease-free survival, overall survival.
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References
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