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Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases
Author(s) -
Zhan Kevin Y.,
Morgan Patrick F.,
Neskey David M.,
Kim Joanne J.,
Huang Andrew T.,
GarrettMayer Elizabeth,
Day Terry A.
Publication year - 2018
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.25178
Subject(s) - medicine , occult , neck dissection , odds ratio , cancer , nodal , confidence interval , carcinoma , gastroenterology , oncology , pathology , alternative medicine
Background Nodal disease predicts survival in oral cavity squamous cell carcinoma (SCC). Currently, no large studies on predictors of occult nodal disease in cT1N0 oral cavity SCC exist. Methods The National Cancer Database (NCDB) review for cT1N0 oral cavity SCC with surgical resection and elective neck dissection (END). Results The number of patients found with occult nodal disease was 2623 (15.1%). In multivariable regression, female sex and tumor differentiation predict occult nodal disease. Occult nodal disease incidence was 5.9% in well‐differentiated tumors, 17.4% in moderately differentiated tumors, and 28.5% in poorly differentiated tumor ( P < .001). Women with oral tongue tumors had higher occult nodal disease (19.1%) than men (12%; P = .001). Adjusted odds ratios (aORs) for occult nodal disease in women were: aOR 1.26; 95% confidence interval (CI) 1.01‐1.59; P = .045; moderately differentiated aOR 3.52; 95% CI 2.47‐5.01; P < .001; and poorly differentiated aOR 6.25; 95% CI 4.17‐9.38; P < .001. Conclusion Sex and tumor differentiation significantly predict occult nodal disease. END is recommended for all moderately and poorly differentiated cT1N0 oral cavity SCC, regardless of the depth of invasion. One can consider not performing END in well‐differentiated tumors.