Elective Neck Dissection Versus Therapeutic Neck Dissection in Clinically Node-Negative Early Stage Oral Cancer: A Meta-analysis of Randomized Controlled Trials

2022 ◽  
Author(s):  
Anshuman Kumar ◽  
Suhani Ghai ◽  
Shubhangi Mhaske ◽  
Renu Singh
Keyword(s):  
Oral Cancer ◽  
Randomized Controlled Trials ◽  
Neck Dissection ◽  
Early Stage ◽  
Meta Analysis ◽  
Elective Neck Dissection ◽  
Controlled Trials ◽  
Node Negative ◽  
Randomized Controlled

Elective versus therapeutic neck dissection in node-negative oral cancer: Evidence from five randomized controlled trials

Oral Oncology ◽  
2015 ◽  
Vol 51 (11) ◽  
pp. 976-981 ◽  
Author(s):  
Zhen-Hu Ren ◽  
Jian-Lin Xu ◽  
Bo Li ◽  
Teng-Fei Fan ◽  
Tong Ji ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Randomized Controlled Trials ◽  
Neck Dissection ◽  
Controlled Trials ◽  
Node Negative ◽  
Randomized Controlled

scholarly journals Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort

2019 ◽  
Vol 121 (10) ◽  
pp. 827-836 ◽  
Author(s):  
Iain L. Hutchison ◽  
Fran Ridout ◽  
Sharon M. Y. Cheung ◽  
Neil Shah ◽  
Peter Hardee ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Neck Dissection ◽  
Early Stage ◽  
Meta Analysis ◽  
Randomised Trial ◽  
Research Network ◽  
Elective Neck Dissection ◽  
Risk Of Death ◽  
Neck Disease ◽  
Observational Cohort

Abstract Background Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours. Methods We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery. Endpoints included overall survival (OS) and disease-free survival (DFS). We conducted a meta-analysis of all six randomised trials. Results Two hundred fifty randomised and 346 observational cohort patients were studied (27 hospitals). Occult neck disease was found in 19.1% (T1) and 34.7% (T2) patients respectively. Five-year intention-to-treat hazard ratios (HR) were: OS HR = 0.71 (p = 0.18), and DFS HR = 0.66 (p = 0.04). Corresponding per-protocol results were: OS HR = 0.59 (p = 0.054), and DFS HR = 0.56 (p = 0.007). END was effective for small tumours. END patients experienced more facial/neck nerve damage; QoL was largely unaffected. The observational cohort supported the randomised findings. The meta-analysis produced HR OS 0.64 and DFS 0.54 (p < 0.001). Conclusion SEND and the cumulative evidence show that within a generalisable setting oral cancer patients who have an upfront END have a lower risk of death/recurrence, even with small tumours. Clinical Trial Registration NIHR UK Clinical Research Network database ID number: UKCRN 2069 (registered on 17/02/2006), ISCRTN number: 65018995, ClinicalTrials.gov Identifier: NCT00571883.

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