Watchful waiting of the neck in early stage oral cancer is unfavourable for patients with occult nodal disease

被引：25
|
作者：
Dik, E. A. [1 ]
Willems, S. M. [2 ]
Ipenburg, N. A. [1 ]
Rosenberg, A. J. W. P. [1 ]
Van Cann, E. M. [3 ]
van Es, R. J. J. [3 ]
机构：
[1] Univ Med Ctr Utrecht, Dept Oral & Maxillofacial Surg, Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Dept Pathol, Utrecht, Netherlands
[3] Univ Med Ctr Utrecht, Dept Head & Neck Surg Oncol, UMC Utrecht Canc Ctr, Utrecht, Netherlands
来源：
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY | 2016年 / 45卷 / 08期
关键词：
oral squamous cell carcinoma; selective neck dissection; watchful waiting; metastasis; extracapsular spread; SQUAMOUS-CELL CARCINOMA; OF-THE-LITERATURE; TUMOR THICKNESS; NEGATIVE NECK; NO NECK; N0; NECK; DISSECTION; TONGUE; CAVITY; SURVIVAL;
D O I：
10.1016/j.ijom.2016.03.007
中图分类号：
R78 [口腔科学];
学科分类号：
1003 ;
摘要：
For cT1/2N0 oral squamous cell carcinoma (OSCC), treatment of the neck is a matter of debate. Two treatment strategies were evaluated in this study: selective neck dissection (SND) and watchful waiting (WW). One hundred and twenty-three SND patients and 70 WW patients with cT1/T2N0M0 OSCC of the tongue, floor of mouth, or buccal mucosa were analysed retrospectively. Extracapsular spread (ECS), 3-year overall survival (OS), and disease-specific survival (DSS) were determined. Twenty-nine percent of SND patients and 13% of WW patients had occult nodal disease. WW-N+ patients showed thicker tumours as compared to WW-N0 patients (5 mm vs. 2 mm, P = 0.02). WW-N+ patients showed significantly more ECS as compared to SND-N+ patients (56% vs. 14%, P = 0.016) and had a significantly worse 3-year DSS than SND-N+ patients (56% vs. 82%, P = 0.02). For T1 OSCCs, a watchful waiting policy is acceptable if tumour thickness proves to be <4 mm. Otherwise, an additional treatment of the neck is advised, since WW-N+ patients show more ECS, with a worse DSS than SND-N+ patients.
引用
收藏
页码：945 / 950
页数：6
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