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Published on: May 10, 2021
Do Patients With T1N0M0 Oral Tongue Squamous Cell Carcinoma (OTSCC) Need Neck Dissection? A Study Based on SEER
Zongyi Yuan1, Yang Zhao2, Huawei Ming1
1Department of Oral and Maxillofacial Surgery, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, Nanchong, Sichuan, China.
Objective:
To identify T1N0M0 oral tongue squamous cell carcinoma (OTSCC) patient subgroups benefiting most from neck dissection (ND) based on the SEER database.
Methods:
Patients with T1N0M0 OTSCC were identified from the SEER database. Propensity score-matching (PSM) was utilized to balance baseline characteristics between ND and non-ND groups. Survival differences between these groups were compared using Kaplan-Meier (K-M) analysis and log-rank tests. Additionally, a multivariable Cox regression model was applied to the pre-matched cohort to identify independent prognostic factors.
Results:
In total, 2426 cases were included. In the multivariable model adjusted for key prognosticators, ND was an independent factor associated with significantly improved OS and DSS. After PSM, 1702 well-balanced patients were analyzed. Subgroup analyses based on tumor characteristics revealed that favorable survival outcomes associated with ND were predominantly observed in patients with tumor sizes 11-20 mm and those with moderate or poor/undifferentiated differentiation. For patients with small tumors (1-10 mm) or well-differentiated histology, survival outcomes were comparable between the ND and observation groups.
Conclusion:
ND was associated with improved survival for T1N0M0 OTSCC patients with 11-20 mm tumors and moderate/poor/undifferentiated differentiation. For patients with smaller tumors (1-10 mm) or well-differentiated histology, the observation strategy had demonstrated survival benefits comparable to ND.
