Oncological Outcome of Node-Positive Oral Squamous Cell Carcinomas Treated With Selective and Comprehensive Neck...

Area of Science:

• Oncology
• Head and Neck Surgery
• Oral Cancer Research

Background:

• Selective neck dissection (SND) is standard for oral squamous cell carcinoma (OSCC) with clinically node-negative (cN0) necks.
• Treatment for clinically node-positive (cN+) OSCC necks involves either SND or comprehensive neck dissection (CND), with ongoing debate regarding the optimal approach.

Purpose of the Study:

• To compare the efficacy of CND versus SND in patients with OSCC and clinically node-positive (cN+) necks.
• To identify independent risk factors affecting overall survival (OS) and disease-free survival (DFS) in this patient cohort.

Main Methods:

• Retrospective analysis of 74 patients with OSCC, clinically (cN+) and pathologically (pN+) positive cervical lymph nodes (LNs).
• Patients were treated with either CND or SND between 2010-2019, with clear neck level categorization.
• Cox regression analysis was employed to assess survival outcomes and risk factors.

Main Results:

• No statistically significant difference was found between CND and SND regarding overall survival (OS) or disease-free survival (DFS).
• Regional recurrence rates were comparable: 5.77% for CND and 9.09% for SND.
• Extracapsular spread (ECS) and male sex were identified as independent risk factors for poorer OS; pT-stage and ECS were independent risk factors for DFS.

Conclusions:

• Both CND and SND can be considered viable treatment options for select patients diagnosed with OSCC and pathologically positive lymph nodes (pN+).
• Treatment decisions should consider patient-specific factors, including pT-stage and the presence of extracapsular spread (ECS).