Decision analysis and treatment threshold in a management for the N0 neck of the oral cavity carcinoma

被引：88
作者：
Okura, Masaya [1 ]
Aikawa, Tomonao [1 ]
Sawai, Natsuko Yoshimura [1 ]
Iida, Seiji [1 ]
Kogo, Mikihiko [1 ]
机构：
[1] Osaka Univ, Grad Sch Dent, Dent Hosp, Dept Oral & Maxillofacial Surg 1, Suita, Osaka 5650871, Japan
来源：
ORAL ONCOLOGY | 2009年 / 45卷 / 10期
关键词：
N0; neck; Occult metastasis; Oral cavity cancer; Head and neck cancer; Elective neck dissection; Wait-and-see; Decision tree; SQUAMOUS-CELL CARCINOMA; TONGUE CARCINOMA; PROGNOSTIC-SIGNIFICANCE; IMPROVED SURVIVAL; NODAL METASTASES; GUIDED CYTOLOGY; STAGE-I; NO NECK; DISSECTION; CANCER;
D O I：
10.1016/j.oraloncology.2009.03.013
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
The optimal method of management of clinical N0 neck in squamous cell carcinoma of the oral cavity remains controversial. We used decision analysis to determine the current optimal strategy in comparison with observation of the neck and elective neck dissection. A total of 165 previously untreated patients with N0 classification were investigated. Probabilities of each recurrence were calculated and probabilities of being cured in each event were substituted with the 5-year overall survival calculation with Kaplan-Meier method. A sensitivity analysis was performed to determine the optimal threshold for treatment of the N0 neck. The threshold of N0 neck was calculated using the formula with putting the three probabilities of being cured. In this study the threshold was estimated at 44.4%. N0 neck of squamous cell carcinoma of the oral cavity should be observed if the probability of occult metastasis is less than 44.4%. Proper calculation of three probabilities of being cured in each institution will make a decision of the optimal method of clinical N0 neck by using the threshold formula. (C) 2009 Elsevier Ltd. All rights reserved.
引用
收藏
页码：908 / 911
页数：4
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