Elective neck dissection improves regional control in early oral squamous cell carcinoma

Thomas Beddow; Tsu-Hui (Hubert) Low; Kan Gao; James Wykes; Ruta Gupta; Jonathan Clark; Michael Elliott

doi:10.21037/ajo-22-20

Elective neck dissection improves regional control in early oral squamous cell carcinoma

Thomas Beddow^*, Tsu-Hui (Hubert) Low, Kan Gao, James Wykes, Ruta Gupta, Jonathan Clark, Michael Elliott

^*Corresponding author for this work

Faculty of Medicine, Health and Human Sciences

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Abstract

Background: Oral squamous cell carcinoma (OSCC) commonly spreads to regional lymph nodes which is associated with reduced survival. The aim of this study was to assess treatment trends in a cohort of T1/T2N0 OSCC patients at an Australian tertiary head and neck cancer (HNC) referral centre over time and their impact on regional control and survival. Methods: A retrospective cohort study of 377 T1/T2N0 OSCC patients was performed. Analysis of treatment trends over time was conducted. Univariate and multivariate analysis was performed to assess the impact of various treatment variables on regional control, disease-specific survival (DSS), overall survival (OS). Results: There were 95 (25.2%) instances of recurrence overall, with 35 (9.3%) regional recurrence as well as 32 deaths (8.5%) from OSCC. An increasing rate of elective neck dissection (END) over time was observed from 1987 to 2019, with rates of 35.6%, 49.2% and 57.4% over consecutive decades (P=0.003). END was associated with increased regional control (HR 0.21, P<0.001). Patients treated with END and observation (Obs) had similar DSS (5-year survival rate END =87% vs. Obs =94%, P=0.11) and OS (5-year survival rate END =71% vs. Obs =71%, P=0.86). Conclusions: END improves regional control in T1/T2N0 OSCC. In patients who do not receive an END, salvage surgery or other therapy in patients with regional recurrence results in comparable DSS and OS to patients who receive END.

Original language	English
Article number	16
Pages (from-to)	1-9
Number of pages	9
Journal	Australian Journal of Otolaryngology
Volume	6
DOIs	https://doi.org/10.21037/ajo-22-20
Publication status	Published - Jun 2023

Bibliographical note

Copyright the Australian Journal of Otolaryngology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

Australia
neck dissection
Oral
recurrence
squamous cell

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Publisher version (open access)Final published version, 293 KBLicence: CC BY-NC-ND

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title = "Elective neck dissection improves regional control in early oral squamous cell carcinoma",

abstract = "Background: Oral squamous cell carcinoma (OSCC) commonly spreads to regional lymph nodes which is associated with reduced survival. The aim of this study was to assess treatment trends in a cohort of T1/T2N0 OSCC patients at an Australian tertiary head and neck cancer (HNC) referral centre over time and their impact on regional control and survival. Methods: A retrospective cohort study of 377 T1/T2N0 OSCC patients was performed. Analysis of treatment trends over time was conducted. Univariate and multivariate analysis was performed to assess the impact of various treatment variables on regional control, disease-specific survival (DSS), overall survival (OS). Results: There were 95 (25.2%) instances of recurrence overall, with 35 (9.3%) regional recurrence as well as 32 deaths (8.5%) from OSCC. An increasing rate of elective neck dissection (END) over time was observed from 1987 to 2019, with rates of 35.6%, 49.2% and 57.4% over consecutive decades (P=0.003). END was associated with increased regional control (HR 0.21, P<0.001). Patients treated with END and observation (Obs) had similar DSS (5-year survival rate END =87% vs. Obs =94%, P=0.11) and OS (5-year survival rate END =71% vs. Obs =71%, P=0.86). Conclusions: END improves regional control in T1/T2N0 OSCC. In patients who do not receive an END, salvage surgery or other therapy in patients with regional recurrence results in comparable DSS and OS to patients who receive END.",

keywords = "Australia, neck dissection, Oral, recurrence, squamous cell",

author = "Thomas Beddow and Low, {Tsu-Hui (Hubert)} and Kan Gao and James Wykes and Ruta Gupta and Jonathan Clark and Michael Elliott",

note = "Copyright the Australian Journal of Otolaryngology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2023",

month = jun,

doi = "10.21037/ajo-22-20",

language = "English",

volume = "6",

pages = "1--9",

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TY - JOUR

T1 - Elective neck dissection improves regional control in early oral squamous cell carcinoma

AU - Beddow, Thomas

AU - Low, Tsu-Hui (Hubert)

AU - Gao, Kan

AU - Wykes, James

AU - Gupta, Ruta

AU - Clark, Jonathan

AU - Elliott, Michael

N1 - Copyright the Australian Journal of Otolaryngology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2023/6

Y1 - 2023/6

N2 - Background: Oral squamous cell carcinoma (OSCC) commonly spreads to regional lymph nodes which is associated with reduced survival. The aim of this study was to assess treatment trends in a cohort of T1/T2N0 OSCC patients at an Australian tertiary head and neck cancer (HNC) referral centre over time and their impact on regional control and survival. Methods: A retrospective cohort study of 377 T1/T2N0 OSCC patients was performed. Analysis of treatment trends over time was conducted. Univariate and multivariate analysis was performed to assess the impact of various treatment variables on regional control, disease-specific survival (DSS), overall survival (OS). Results: There were 95 (25.2%) instances of recurrence overall, with 35 (9.3%) regional recurrence as well as 32 deaths (8.5%) from OSCC. An increasing rate of elective neck dissection (END) over time was observed from 1987 to 2019, with rates of 35.6%, 49.2% and 57.4% over consecutive decades (P=0.003). END was associated with increased regional control (HR 0.21, P<0.001). Patients treated with END and observation (Obs) had similar DSS (5-year survival rate END =87% vs. Obs =94%, P=0.11) and OS (5-year survival rate END =71% vs. Obs =71%, P=0.86). Conclusions: END improves regional control in T1/T2N0 OSCC. In patients who do not receive an END, salvage surgery or other therapy in patients with regional recurrence results in comparable DSS and OS to patients who receive END.

AB - Background: Oral squamous cell carcinoma (OSCC) commonly spreads to regional lymph nodes which is associated with reduced survival. The aim of this study was to assess treatment trends in a cohort of T1/T2N0 OSCC patients at an Australian tertiary head and neck cancer (HNC) referral centre over time and their impact on regional control and survival. Methods: A retrospective cohort study of 377 T1/T2N0 OSCC patients was performed. Analysis of treatment trends over time was conducted. Univariate and multivariate analysis was performed to assess the impact of various treatment variables on regional control, disease-specific survival (DSS), overall survival (OS). Results: There were 95 (25.2%) instances of recurrence overall, with 35 (9.3%) regional recurrence as well as 32 deaths (8.5%) from OSCC. An increasing rate of elective neck dissection (END) over time was observed from 1987 to 2019, with rates of 35.6%, 49.2% and 57.4% over consecutive decades (P=0.003). END was associated with increased regional control (HR 0.21, P<0.001). Patients treated with END and observation (Obs) had similar DSS (5-year survival rate END =87% vs. Obs =94%, P=0.11) and OS (5-year survival rate END =71% vs. Obs =71%, P=0.86). Conclusions: END improves regional control in T1/T2N0 OSCC. In patients who do not receive an END, salvage surgery or other therapy in patients with regional recurrence results in comparable DSS and OS to patients who receive END.

KW - Australia

KW - neck dissection

KW - Oral

KW - recurrence

KW - squamous cell

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U2 - 10.21037/ajo-22-20

DO - 10.21037/ajo-22-20

M3 - Article

AN - SCOPUS:85164966807

SN - 2616-2792

VL - 6

SP - 1

EP - 9

JO - Australian Journal of Otolaryngology

JF - Australian Journal of Otolaryngology

M1 - 16

ER -

Elective neck dissection improves regional control in early oral squamous cell carcinoma

Abstract

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