Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-11-2016 | Head and Neck

The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma

Authors: Nayuta Tsushima, Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Tomohiko Kakizaki, Takayoshi Suzuki, Satoshi Fukuda

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2016

Abstract

Prophylactic neck dissection (PND) for patients with clinically N0 (cN0) tongue carcinoma remains controversial. We assessed the efficacy of PND for patients with cN0 tongue squamous cell carcinoma (SCC) and investigated the prognostic role of tumor thickness as assessed by diagnostic imaging in predicting the risk of nodal micrometastasis or late nodal recurrence. Eighty-eight patients with cN0 tongue carcinomas underwent surgical treatment. Tumor thickness was measured from magnetic resonance (MR) images or computed tomography (CT) scans. The overall survival rates of patients with or without PND were 94 and 81 %, respectively (p = 0.2857). MR images or CT scans were available for 68 patients. A tumor thickness ≥10 mm or ≥5 mm did not increase the probability of nodal metastasis, with late nodal metastasis observed in 15 % of patients with graphically undetected small tumors. PND appears to have the potential to improve overall survival for patients with cN0 tongue SCC. Careful follow-up management or PND is considered to be needed regardless of tumor thickness in the pre-treatment evaluation.

Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRefPubMed

Almangush A, Bello IO, Coletta RD et al (2015) For early-stage oral tongue cancer, depth of invasion and worst pattern of invasion are the strongest pathological predictors for locoregional recurrence and mortality. Virchows Arch 467:39–46CrossRefPubMed

Capote A, Escorial V, Muñoz-Guerra MF et al (2007) Elective neck dissection in early-stage oral squamous cell carcinoma—does it influence recurrence and survival? Head Neck 29:3–11CrossRefPubMed

D’Cruz AK, Vaish R, Kapre N et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373:521–529CrossRefPubMed

Beenken SW, Krontiras H, Maddox WA et al (1999) T1 and T2 squamous cell carcinoma of the oral tongue: prognostic factors and the role of elective lymph node dissection. Head Neck 21:124–130CrossRefPubMed

Yuen AP, Lam KY, Wei WI et al (2000) A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma. Am J Surg 180:139–143CrossRefPubMed

Lwin CT, Hanlon R, Lowe D et al (2012) Accuracy of MRI in prediction of tumour thickness and nodal stage in oral squamous cell carcinoma. Oral Oncol 48:149–154CrossRefPubMed

Lim SC, Zhang S, Ishii G et al (2004) Predictive markers for late cervical metastasis in stage I and II invasive squamous cell carcinoma of the oral tongue. Clin Cancer Res 10:166–172CrossRefPubMed

Huang SF, Kang CJ, Lin CY et al (2008) Neck treatment of patients with early stage oral tongue cancer: comparison between observation, supraomohyoid dissection, and extended dissection. Cancer 112:1066–1075CrossRefPubMed

10.

Yuen AP, Ho CM, Chow TL et al (2009) Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma. Head Neck 31:765–772CrossRefPubMed

11.

Haddadin KJ, Soutar DS, Oliver RJ et al (1999) Improved survival for patients with clinically T1/T2, N0 tongue tumors undergoing a prophylactic neck dissection. Head Neck 21:517–525CrossRefPubMed

12.

Godden DR, Ribeiro NF, Hassanein K et al (2002) Recurrent neck disease in oral cancer. J Oral Maxillofac Surg 60:748–753CrossRefPubMed

13.

Ren ZH, Xu JL, Li B et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer: evidence from five randomized controlled trials. Oral Oncol 51:976–981CrossRefPubMed

14.

Bernier J, Cooper JS, Pajak TF et al (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27:843–850CrossRefPubMed

15.

Fakih AR, Rao RS, Borges AM et al (1989) Elective versus therapeutic neck dissection in early carcinoma of the oral tongue. Am J Surg 158:309–313CrossRefPubMed

Title: The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma
Authors: Nayuta Tsushima
Tomohiro Sakashita
Akihiro Homma
Hiromitsu Hatakeyama
Satoshi Kano
Takatsugu Mizumachi
Tomohiko Kakizaki
Takayoshi Suzuki
Satoshi Fukuda
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-4077-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2016

A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection

The Carina© middle ear implant: surgical and functional outcomes

Determining vestibular hypofunction: start with the video-head impulse test

A clinical assessment of cochlear implant recipient performance: implications for individualized map settings in specific environments

Long-term follow-up after “one-shot” CO2 laser stapedotomy: is the functional outcome stable during the years?

Hyperbaric oxygen therapy as an alternative to surgery for non-healing pharyngocutaneous fistula