دورية أكاديمية
أعرض في EDS

Occult metastasis is no burden factor in oral squamous cell carcinoma patients when adhering to a standardized approach in neck dissection.

التفاصيل البيبلوغرافية
العنوان: Occult metastasis is no burden factor in oral squamous cell carcinoma patients when adhering to a standardized approach in neck dissection.
المؤلفون: Struckmeier AK; Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany. ann-kristin.struckmeier@uk-erlangen.de.; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany. ann-kristin.struckmeier@uk-erlangen.de., Buchbender M; Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany.; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany., Moest T; Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany.; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany., Lutz R; Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany.; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany., Agaimy A; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany.; Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany., Kesting M; Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany.; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany.
المصدر: Clinical oral investigations [Clin Oral Investig] 2024 Jan 24; Vol. 28 (1), pp. 113. Date of Electronic Publication: 2024 Jan 24.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9707115 Publication Model: Electronic Cited Medium: Internet ISSN: 1436-3771 (Electronic) Linking ISSN: 14326981 NLM ISO Abbreviation: Clin Oral Investig
أسماء مطبوعة: Publication: Berlin : Springer-Verlag
Original Publication: Berlin : Springer, c1997-
مواضيع طبية MeSH: Carcinoma, Squamous Cell*/surgery , Mouth Neoplasms*/surgery , Head and Neck Neoplasms*, Metrizamide/*analogs & derivatives, Male ; Humans ; Squamous Cell Carcinoma of Head and Neck ; Neck Dissection ; Retrospective Studies ; Lymphatic Metastasis
مستخلص: Objectives: Management of the neck in patients with oral squamous cell carcinoma (OSCC) is pivotal to oncologic control and survival. However, there is controversy regarding necessity of neck dissection (ND) in patients with clinically node-negative neck. We aimed to assess risk factors for occult metastasis and to explore whether the presence of occult lymph node metastases (LNMs) has an impact on recurrence and survival.
Material and Methods: A retrospective cohort study was performed including patients with primary OSCC who underwent radical tumor resection and ND in a high-volume center adhering to the prevailing German guideline. The ND was performed according to a standardized approach.
Results: Four hundred twenty-one patients with primary surgically treated OSCC were included. The incidence of occult metastasis was 14.49%. A pathological T stage > 1 (multivariate analysis, odds ratio (OR) 3.958, p = 0.042) and the presence of extranodal extension in LNMs (multivariate analysis, OR 0.287, p = 0.020) were identified as independent risk factors for occult metastasis. When comparing patients with and without occult metastasis, there were no significant differences in terms of progression-free survival (log-rank, p = 0.297) and overall survival (log-rank, p = 0.320). There were no cases of ipsilateral neck recurrence. One patient developed contralateral neck metastasis; however, he initially presented with a unilateral pT1 pN0 tumor.
Conclusions: Overall, our findings suggest that conducting a standardized approach in ND should be applied in terms of management of the neck in order to maintain survival rates and to prevent neck recurrence in OSCC patients.
Clinical Relevance: None of the risk factors for occult metastasis can be reliably assessed preoperatively. Although elective ND does not guarantee the complete prevention of neck recurrence, it increases the likelihood of either timely removal of micrometastases or strengthens the justification for adjuvant therapy. Consequently, this approach leads to improvements in clinical outcomes.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Lymph node metastasis; Neck dissection; Occult metastasis; Oral squamous cell carcinoma
المشرفين على المادة: 56562-79-9 (P297)
RHH3W8F1CO (Metrizamide)
تواريخ الأحداث: Date Created: 20240124 Date Completed: 20240126 Latest Revision: 20240207
رمز التحديث: 20240207
مُعرف محوري في PubMed: PMC10808318
DOI: 10.1007/s00784-024-05514-8
PMID: 38267767
قاعدة البيانات: MEDLINE
الوصف
تدمد:1436-3771
DOI:10.1007/s00784-024-05514-8