Serial Step Sectioning for Pathologically Node-Negative Oral Cancer: Echelon Node Evaluation and Failure Analysis for...

Area of Science:

• Oncology
• Head and Neck Surgery
• Pathology

Background:

• Elective neck dissection (END) is standard for node-negative oral cancer, improving survival.
• Despite END, regional recurrence remains a challenge, impacting long-term outcomes.

Purpose of the Study:

• To evaluate the role of the echelon node in pathologically node-negative oral cancer patients who experienced regional or distant failures.
• To identify occult metastasis features using serial step sectioning (SSS).

Main Methods:

• Retrospective single-centre study analyzing 96 patients with node-negative oral cancer.
• Utilized serial step sectioning (SSS) to detect isolated tumor cells (ITCs) and micrometastases (miMets).

Main Results:

• Adverse pathological features like lymphovascular invasion (LVI), perineural invasion (PNI), and depth of invasion (DOI) were significantly associated with nodal recurrence.
• No micrometastases were detected in this cohort; further research with larger groups is suggested.

Conclusions:

• Meticulous pathological assessment is crucial for node-negative oral cancer patients.
• Adjuvant therapy may help mitigate recurrence risks.
• Standardized reporting and adequate lymph node yield are vital for optimizing outcomes.