Evidence map›Paper›PMID 38169115›Full record

ArticleCancer medicine2024

Is elective neck dissection justified in cT2N0M0 oral cavity cancer defined according to the AJCC eighth edition staging system?

Tsung-Ming Chen, Shyuang-Der Terng, Li-Yu Lee, Shu-Ru Lee, Shu-Hang Ng, Chung-Jan Kang, Jin-Ching Lin, Chih-Yen Chien, Chun-Hung Hua, Cheng Ping Wang and 21 more

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Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

31 authors at 7 institutions in 1 country.

Tsung-Ming ChenDepartment of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC.
Shyuang-Der TerngDepartment of Head and Neck Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan, ROC.
Li-Yu LeeDepartment of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Shu-Ru LeeResearch Service Center for Health Information, Chang Gung University, Taoyuan, Taiwan, ROC.
Shu-Hang NgDepartment of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Chung-Jan KangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0002-5333-9396
Jin-Ching LinDepartment of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan, ROC.
Chih-Yen ChienDepartment of Otolaryngology, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
Chun-Hung HuaDepartment of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, ROC.
Cheng Ping WangDepartment of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, ROC.
Wen-Cheng ChenDepartment of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0002-6335-8670
Yao-Te TsaiDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC.
Chi-Ying TsaiDepartment of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Chien-Yu LinDepartment of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0002-0972-9397
Kang-Hsing FanDepartment of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Hung-Ming WangDepartment of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Chia-Hsun HsiehDepartment of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0002-5547-409X
Chih-Hua YehDepartment of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0001-6988-8739
Chih-Hung LinDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Chung-Kan TsaoDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Nai-Ming ChengDepartment of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Tuan-Jen FangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Shiang-Fu HuangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Li-Ang LeeDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0001-8414-595X
Ku-Hao FangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Yu-Chien WangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Wan-Ni LinDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Li-Jen HsinDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Tzu-Chen YenDepartment of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Yu-Wen WenClinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan, ROC.
Chun-Ta LiaoDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.ORCID 0000-0002-3677-4249
Chang Gung University · TWChanghua Christian Hospital · TWChiayi Chang Gung Memorial Hospital · TWChina Medical University · TWKoo Foundation Sun Yat-Sen Cancer Center · TWNational Taiwan University Hospital · TWTaipei Medical University-Shuang Ho Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe current NCCN guidelines recommend considering elective neck dissection (END) for early-stage oral cavity squamous cell carcinoma (OCSCC) with a depth of invasion (DOI) exceeding 3 mm. However, this DOI threshold, determined by evaluating the occult lymph node metastatic rate, lacks robust supporting evidence regarding its impact on patient outcomes. In this nationwide study, we sought to explore the specific indications for END in patients diagnosed with OCSCC at stage cT2N0M0, as defined by the AJCC Eighth Edition staging criteria.

methodsWe examined 4723 patients with cT2N0M0 OCSCC, of which 3744 underwent END and 979 were monitored through neck observation (NO).

resultsPatients who underwent END had better 5-year outcomes compared to those in the NO group. The END group had higher rates of neck control (95% vs. 84%, p < 0.0001), disease-specific survival (DSS; 87% vs. 84%, p = 0.0259), and overall survival (OS; 79% vs. 73%, p = 0.0002). Multivariable analysis identified NO, DOI ≥5.0 mm, and moderate-to-poor tumor differentiation as independent risk factors for 5-year neck control, DSS, and OS. Based on these prognostic variables, three distinct outcome subgroups were identified within the NO group. These included a low-risk subgroup (DOI <5 mm plus well-differentiated tumor), an intermediate-risk subgroup (DOI ≥5.0 mm or moderately differentiated tumor), and a high-risk subgroup (poorly differentiated tumor or DOI ≥5.0 mm plus moderately differentiated tumor). Notably, the 5-year survival outcomes (neck control/DSS/OS) for the low-risk subgroup within the NO group (97%/95%/85%, n = 251) were not inferior to those of the END group (95%/87%/79%).

conclusionsBy implementing risk stratification within the NO group, we found that 26% (251/979) of low-risk patients achieved outcomes similar to those in the END group. Therefore, when making decisions regarding the implementation of END in patients with cT2N0M0 OCSCC, factors such as DOI and tumor differentiation should be taken into account.

Indexed as

Elective Surgical ProceduresMouth NeoplasmsNeck DissectionNeoplasm StagingAdultAgedCarcinoma, Squamous CellFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessPrognosisRetrospective StudiesSquamous Cell Carcinoma of Head and Neckcancer registryclinical outcomescT2N0M0elective neck dissectionoccult lymph node metastasisoral cavity squamous cell carcinoma

Identifiers

PMID38169115
PMCPMC10807631
OpenAlexW4390538022

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.