scholarly journals Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma?

2021 ◽  
Vol 11 ◽  
Author(s):  
Yassine Aaboubout ◽  
Quincy M. van der Toom ◽  
Maria A. J. de Ridder ◽  
Maria J. De Herdt ◽  
Berdine van der Steen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Early Stage ◽  
Elective Neck Dissection ◽  
Depth Of Invasion ◽  
Node Metastasis ◽  
Occult Lymph Node Metastasis

ObjectiveThe depth of invasion (DOI) is considered an independent risk factor for occult lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC). It is used to decide whether an elective neck dissection (END) is indicated in the case of a clinically negative neck for early stage carcinoma (pT1/pT2). However, there is no consensus on the cut-off value of the DOI for performing an END. The aim of this study was to determine a cut-off value for clinical decision making on END, by assessing the association of the DOI and the risk of occult lymph node metastasis in early OCSCC.MethodsA retrospective cohort study was conducted at the Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Patients surgically treated for pT1/pT2 OCSCC between 2006 and 2012 were included. For all cases, the DOI was measured according to the 8th edition of the American Joint Committee on Cancer guideline. Patient characteristics, tumor characteristics (pTN, differentiation grade, perineural invasion, and lymphovascular invasion), treatment modality (END or watchful waiting), and 5-year follow-up (local recurrence, regional recurrence, and distant metastasis) were obtained from patient files.ResultsA total of 222 patients were included, 117 pT1 and 105 pT2. Occult lymph node metastasis was found in 39 of the 166 patients who received END. Univariate logistic regression analysis showed DOI to be a significant predictor for occult lymph node metastasis (odds ratio (OR) = 1.3 per mm DOI; 95% CI: 1.1–1.5, p = 0.001). At a DOI of 4.3 mm the risk of occult lymph node metastasis was >20% (all subsites combined).ConclusionThe DOI is a significant predictor for occult lymph node metastasis in early stage oral carcinoma. A NPV of 81% was found at a DOI cut-off value of 4 mm. Therefore, an END should be performed if the DOI is >4 mm.

scholarly journals Elective neck dissection versus watchful waiting in the management of early tongue cancers with node negative neck: our experience of 68 cases

2021 ◽  
Author(s):  
Anchal Gupta ◽  
Rupali Sharma ◽  
Gopika Kalsotra ◽  
Arun Manhas ◽  
Dev Raj
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Primary Tumor ◽  
Surgical Excision ◽  
Tumor Thickness ◽  
Elective Neck Dissection ◽  
Node Metastasis

<p><strong>Background: </strong>Prognosis for tongue squamous cell carcinoma depends upon lymph node metastasis and the treatment plan depends upon the management of cervical lymph node metastasis.<strong></strong></p><p><strong>Methods: </strong>A prospective analysis of early squamous cell carcinoma oral tongue was done February 2017 to February 2020 in previously untreated and biopsy proven patients with T1-2N0 cancer of tongue and patients with clinically negative nodes on the basis of palpation, ultrasound and computerized tomography (CT) and previously untreated and biopsy proven patients with T1-2N0 cancer of oral cavity. After proper work up, patients were divided into two groups. Group 1 (n=35) patients that underwent a surgical excision of primary tumor with 15mm safe margin and selective neck dissection (level I, II, III), group 2 (n=33) patients that underwent surgical excision of primary tumor with 15 mm safe margin and neck observation. All patients with tumor thickness ≥4 mm were included in this group. </p><p><strong>Results: </strong>The study included 51 (75%) males and 17(25%) female patients. In this study, recurrence was significantly related to tumor thickness (p&lt;0.05) i.e., &gt;4 mm tumor thickness showed significantly higher local recurrence and nodal recurrences. Also, a significantly higher relationship was seen between nodal recurrence and postoperative close surgical margins (p&lt;0.05).</p><p><strong>Conclusions: </strong>Elective neck dissection becomes necessary in patients with T2N0 tumors and tumor thickness of &gt;4 mm as frequency of occult metastasis and recurrence is more in these patients.</p>

Level IIb lymph node metastasis in elective neck dissection of oropharyngeal squamous cell carcinoma

Oral Oncology ◽  
2006 ◽  
Vol 42 (10) ◽  
pp. 1017-1021 ◽  
Author(s):  
Sei Young Lee ◽  
Young Chang Lim ◽  
Mee Hyun Song ◽  
Jin Seok Lee ◽  
Bon Seok Koo ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Elective Neck Dissection ◽  
Node Metastasis

scholarly journals Significance of SUV Max for Predicting Occult Lymph Node Metastasis and Prognosis in Early-Stage Tongue Squamous Cell Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Chunmiao Xu ◽  
Hailiang Li ◽  
Dongjie Seng ◽  
Fei Liu
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Occult Metastasis ◽  
Node Metastasis ◽  
The Difference ◽  
Occult Lymph Node Metastasis

Objective. Our goal was to clarify the significance of SUV max for predicting occult lymph node metastasis and prognosis in early-stage tongue squamous cell carcinoma (SCC). Methods. cT1-2N0 tongue SCC patients who underwent a preoperative PET-CT examination were prospectively enrolled. The association between SUV max and occult lymph node metastasis was analyzed. The main study endpoint was locoregional control (LRC). The Cox model was used to determine the independent factors. Results. A total of 120 patients were included for analysis, and the median SUV max was 9.7. In 60 patients with an SUV max ≤9.7, 5 patients had occult metastasis; in 60 patients with an SUV max >9.7, 13 patients had occult metastasis, and the difference was significant (p=0.041). In patients with an SUV max ≤9.7, the 5-year LRC rate was 93%; in patients with an SUV max >9.7, the 5-year LRC rate was 81%, and the difference was significant (p=0.045). Conclusion. An SUV max >9.7 was a marker for occult lymph node metastasis and could decrease LRC in patients with cT1-2N0 tongue SCC.

scholarly journals A nomogram to predict lymph node metastasis risk for early esophageal squamous cell carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofeng Duan ◽  
Xiaobin Shang ◽  
Jie Yue ◽  
Zhao Ma ◽  
Chuangui Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Derivation Cohort ◽  
Node Metastasis

Abstract Background A nomogram was developed to predict lymph node metastasis (LNM) for patients with early-stage esophageal squamous cell carcinoma (ESCC). Methods We used the clinical data of ESCC patients with pathological T1 stage disease who underwent surgery from January 2011 to June 2018 to develop a nomogram model. Multivariable logistic regression was used to confirm the risk factors for variable selection. The risk of LNM was stratified based on the nomogram model. The nomogram was validated by an independent cohort which included early ESCC patients underwent esophagectomy between July 2018 and December 2019. Results Of the 223 patients, 36 (16.1%) patients had LNM. The following three variables were confirmed as LNM risk factors and were included in the nomogram model: tumor differentiation (odds ratio [OR] = 3.776, 95% confidence interval [CI] 1.515–9.360, p = 0.004), depth of tumor invasion (OR = 3.124, 95% CI 1.146–8.511, p = 0.026), and tumor size (OR = 2.420, 95% CI 1.070–5.473, p = 0.034). The C-index was 0.810 (95% CI 0.742–0.895) in the derivation cohort (223 patients) and 0.830 (95% CI 0.763–0.902) in the validation cohort (80 patients). Conclusions A validated nomogram can predict the risk of LNM via risk stratification. It could be used to assist in the decision-making process to determine which patients should undergo esophagectomy and for which patients with a low risk of LNM, curative endoscopic resection would be sufficient.

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