Contralateral neck failure in lateralized oral squamous cell carcinoma

Area of Science:

• Oncology
• Head and Neck Surgery
• Cancer Research

Background:

• Lateralized oral cavity squamous cell carcinoma (SCC) management often omits elective contralateral neck treatment.
• Current guidelines do not routinely recommend contralateral neck treatment for clinically node-negative (cN0) lateralized oral SCC.

Purpose of the Study:

• To determine the failure rate in the untreated contralateral neck for lateralized oral SCC patients.
• To identify risk factors for contralateral regional failure that may warrant elective treatment.

Main Methods:

• Analysis of 481 patients with lateralized oral SCC treated between 1985 and 2012.
• Exclusion of patients with midline primaries or bilateral neck treatment.
• Primary endpoint: isolated contralateral neck failure.

Main Results:

• 14 out of 481 patients (2.9%) experienced isolated contralateral neck recurrence.
• Poorly differentiated tumors and ipsilateral nodal metastases were significant risk factors (HR 3.6 and 4.6, respectively).
• Patients with both risk factors had a 10% risk of contralateral failure.

Conclusions:

• The rate of isolated contralateral neck failure is low in lateralized oral SCC.
• While certain factors increase risk, the overall risk remains modest, supporting observation over elective treatment.
• Results align with current recommendations for observing the cN0 contralateral neck.