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Improved survival with elective neck dissection in thick early‐stage oral squamous cell carcinoma
Author(s) -
Ebrahimi Ardalan,
Ashford Bruce G.,
Clark Jonathan R.
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21809
Subject(s) - medicine , neck dissection , dissection (medical) , surgery , stage (stratigraphy) , head and neck squamous cell carcinoma , hazard ratio , basal cell , head and neck , carcinoma , head and neck cancer , radiation therapy , confidence interval , paleontology , biology
Background Management of the node–negative neck in T1 to T2 oral squamous cell carcinoma (SCC) remains controversial. The purpose of this study was to determine if elective neck dissection improves outcomes in thick primary tumors since this reflects current practice in most institutions and has not been specifically addressed in the literature. Methods Retrospective analysis comparing elective neck dissection versus observation in 153 patients with T1 to T2 N0 oral SCC ≥4 mm thick. Results On multivariable analysis, elective neck dissection was a significant predictor of improved regional control (hazard ratio [HR], 0.1; p < .001), disease‐specific (HR, 0.1; p < .001), and overall survival (HR, 0.3; p = .001). Regional failure accounted for 22% of disease‐related deaths in the elective neck dissection group compared to 92% in the observation arm. Conclusion Elective neck dissection is associated with a clinically significant survival advantage in thick T1 to T2 oral SCC by reducing the risk of regional failure, and we support its routine application in these patients. © 2011 Wiley Periodicals, Inc. Head Neck, 2012