J Korean Assoc Oral Maxillofac Surg.  2016 Dec;42(6):358-364. 10.5125/jkaoms.2016.42.6.358.

Elective neck dissection versus observation in early stage oral squamous cell carcinoma: recurrence and survival

• Kim DW
• Lee BD
• Lim JH
• Park JH
• Nam W
• Kim HJ
• Cha IH

• KMID: 2364003
• DOI: http://doi.org/10.5125/jkaoms.2016.42.6.358

Abstract

OBJECTIVES
To evaluate the results of elective neck dissection versus those of observation in the treatment of early stage oral squamous cell carcinoma and to identify factors related to recurrence and survival.
MATERIALS AND METHODS
This was a retrospective study of 52 patients who underwent elective neck dissection and 27 who did not receive neck dissection.
RESULTS
In survival analyses, elective neck dissection showed a benefit in overall recurrence (P=0.027), especially in stage I patients (P=0.024). With regard to survival, the benefit was statistically insignificant (P=0.990). In multivariable analysis, overall recurrence was independently related to poor histologic grade (odds ratio [OR]=9.65, P=0.006), and cancer-specific death was independently related to advanced age (OR=6.3, P=0.022), higher clinical T stage (OR=15.2, P=0.01), and poorly differentiated histologic grade (OR=6.6, P=0.025).
CONCLUSION
Though there was lower recurrence in the elective neck dissection group, there were no statistically significant results on survival. The characteristics of the tumor itself, such as clinical T stage and poor histologic grade, may be more important in cancer-specific survival.

Keyword

Oral cancer; Squamous cell carcinoma; Neck dissection; Survival analysis; Survival rate

MeSH Terms

Carcinoma, Squamous Cell*
Epithelial Cells*
Humans
Mouth Neoplasms
Neck Dissection*
Neck*
Recurrence
Retrospective Studies
Survival Analysis
Survival Rate

Figure

• 

  Fig. 1 Disease-free survival. There was a statistically significant difference between observation (OBS) and elective neck dissection (END) groups (P=0.027).

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  Fig. 2 Disease-free survival in stage I and II patients. In stage I patients, there was a significant difference between observation (OBS) and elective neck dissection (END) groups (stage I, P=0.024; stage II, P=0.373). Statistical analysis by Kaplan-Meier survival estimates and log-rank test.

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  Fig. 3 Regional recurrence-free survival. No significant difference between observation (OBS) and elective neck dissection (END) groups (P=0.990). Statistical analysis by Kaplan-Meier survival estimates and log-rank test.

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  Fig. 4 Cancer-specific survival. No significant difference between observation (OBS) and elective neck dissection (END) groups (P=0.990). Statistical analysis by Kaplan-Meier survival estimates and log-rank test.

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