دورية أكاديمية
أعرض في EDS

Elective Neck Dissection for cT1-4 N0M0 Head and Neck Verrucous Carcinoma.

التفاصيل البيبلوغرافية
العنوان: Elective Neck Dissection for cT1-4 N0M0 Head and Neck Verrucous Carcinoma.
المؤلفون: Patel AM; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA., Vedula S; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA., Haleem A; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA., Choudhry HS; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA., Tseng CC; Department of Otolaryngology-Head and Neck Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA., Park RCW; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
المصدر: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Nov; Vol. 169 (5), pp. 1187-1199. Date of Electronic Publication: 2023 Jun 06.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: England NLM ID: 8508176 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6817 (Electronic) Linking ISSN: 01945998 NLM ISO Abbreviation: Otolaryngol Head Neck Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2023- : [Oxford] : Wiley
Original Publication: [Rochester, Minn.] : The Academy, [c1981-
مواضيع طبية MeSH: Carcinoma, Squamous Cell*/pathology , Head and Neck Neoplasms*/surgery , Head and Neck Neoplasms*/pathology , Carcinoma, Verrucous*/surgery , Carcinoma, Verrucous*/pathology, Humans ; Male ; Female ; Retrospective Studies ; Neck Dissection ; Elective Surgical Procedures ; Neoplasm Staging
مستخلص: Objective: To investigate the survival benefit of elective neck dissection (END) over neck observation in cT1-4 N0M0 head and neck verrucous carcinoma (HNVC).
Study Design: Retrospective cohort study.
Setting: The 2006 to 2017 National Cancer Database.
Methods: Patients with surgically resected cT1-4 N0M0 HNVC were selected. Linear, binary logistic, Kaplan-Meier, and Cox proportional hazards regression models were utilized.
Results: Of 1015 patients satisfying inclusion criteria, 223 (22.0%) underwent END. The majority of patients were male (55.4%) and white (91.0%) with disease of the oral cavity (67.6%) classified as low grade (90.0%) and cT1-2 (81.8%). The minority of ENDs (4.0%) detected occult nodal metastases. The rate of END increased from 2006 to 2017 for both cT1-2 (16.3% vs 22.0%, p = .126, R 2  = 0.405) and cT3-4 (41.7% vs 70.0%, p = .424, R 2  = 0.232) disease but these trends were not statistically significant. Independent predictors of undergoing END included treatment at an academic facility (adjusted odds ratio [aOR]: 1.75, 95% confidence interval [CI]: 1.19-2.55), cT3-4 disease (aOR: 3.31, 95% CI: 2.16-5.07), and tumor diameter (aOR: 1.09, 95% CI: 1.01-1.19) (p < 0.05). The 5-year overall survival (OS) of patients treated with and without END was 71.3% and 70.6%, respectively (p = .661). END did not significantly reduce the 5-year hazard of death (adjusted hazard ratio: 1.25, 95% CI: 0.91-1.71, p = .172). END did not significantly improve 5-year OS in univariate and multivariate analyses stratified by several patient, facility, tumor, and treatment characteristics.
Conclusion: END does not confer an appreciable survival benefit in HNVC, even after stratifying univariate and multivariate analyses by several patient, facility, tumor, and treatment characteristics.
Level of Evidence: Level 4.
(© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
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فهرسة مساهمة: Keywords: National Cancer Database; head and neck cancer; neck dissection; occult; verrucous carcinoma
تواريخ الأحداث: Date Created: 20230606 Date Completed: 20231026 Latest Revision: 20231112
رمز التحديث: 20231215
DOI: 10.1002/ohn.374
PMID: 37278222
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6817
DOI:10.1002/ohn.374