Evidence map›Paper›PMID 39681094›Full record

ArticleORL; journal for oto-rhino-laryngology and its related specialties2024

Level V Metastases in Node-Positive Oral Squamous Cell Carcinoma: Beyond Level IIA and III.

Kinjal Shankar Majumdar, Vikramjit Singh Kailey, Akash Varshney, Thaduri Abhinav, Achyuth Panuganti, Shahab Ali Usmani, Pallvi Kaul, Dungala Dileep Maharaj, Abhijeet Singh, Areej Moideen and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ORL; journal for oto-rhino-laryngology and its related specialties, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Kinjal Shankar MajumdarDepartment of Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
Vikramjit Singh KaileyMohandai Oswal Hospital, Ludhiana, India.
Akash VarshneyDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Thaduri AbhinavDepartment of ENT, Prathima Relief Institute of Medical Sciences, Warangal, India.
Achyuth PanugantiDepartment of ENT, Mediciti Institute of Medical Sciences, Medchal, India.
Shahab Ali UsmaniRemedy Comprehensive Cancer Centre, Lucknow, India.
Pallvi KaulDepartment of Surgical Oncology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India.
Dungala Dileep MaharajSeven Hills Hospital, Vishakhapatnam, India.
Abhijeet SinghDepartment of Otolaryngology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.
Areej MoideenDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
Ramesh PrasathDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Nivedhan RavichandranDepartment of Otolaryngology - Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Nongthombam Surjalata DeviDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
Abhishek BhardwajDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Madhu PriyaDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Manu MalhotraDepartment of Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSurgical management of level V in clinically node positive (cN+) oral squamous cell carcinomas (OSCCs) is controversial. The objectives of the study were to identify predictors of level V metastases in cN+ OSCC.

methodsThis retrospective study is based on institutional data of operated cN+ OSCC between April 2018 and December 2022. Clinical and pathological parameters were subjected to univariate analysis. Significant parameters in univariate analysis were further subjected to multivariate analysis. A p value of less than 0.05 was considered statistically significant.

resultsNone of cN1 or pN1 patients had a level V metastasis. No skip metastasis to level-V was noticed. Total number of positive lymph nodes, lymph node ratio (LNR), extranodal extension, pN classification, and the presence of level II and III metastases were found to be significant predictors for level V metastases. The post hoc analysis suggested that ≥5 positive nodes, LNR >0.1, and pN3 status were independent risk factors for level V metastases.

conclusionSelective neck dissection for N+ OSCC is feasible in the N1 neck, preferably where nodal metastases is limited to level-I only. Patients with a bulky nodal disease, particularly those with N3 neck, ≥5 positive nodes, ENE, and metastatic lymph nodes in levels II and III should be offered comprehensive neck dissection.

introductionSurgical management of level V in clinically node positive (cN+) oral squamous cell carcinomas (OSCCs) is controversial. The objectives of the study were to identify predictors of level V metastases in cN+ OSCC.

methodsThis retrospective study is based on institutional data of operated cN+ OSCC between April 2018 and December 2022. Clinical and pathological parameters were subjected to univariate analysis. Significant parameters in univariate analysis were further subjected to multivariate analysis. A p value of less than 0.05 was considered statistically significant.

resultsNone of cN1 or pN1 patients had a level V metastasis. No skip metastasis to level-V was noticed. Total number of positive lymph nodes, lymph node ratio (LNR), extranodal extension, pN classification, and the presence of level II and III metastases were found to be significant predictors for level V metastases. The post hoc analysis suggested that ≥5 positive nodes, LNR >0.1, and pN3 status were independent risk factors for level V metastases.

conclusionSelective neck dissection for N+ OSCC is feasible in the N1 neck, preferably where nodal metastases is limited to level-I only. Patients with a bulky nodal disease, particularly those with N3 neck, ≥5 positive nodes, ENE, and metastatic lymph nodes in levels II and III should be offered comprehensive neck dissection.

Indexed as

Carcinoma, Squamous CellLymph NodesMouth NeoplasmsNeck DissectionAdultAgedAged, 80 and overFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm StagingRetrospective StudiesCervical nodal metastasisHead and neck cancerHead and neck malignancyHead and neck squamous cell carcinomaMetastasesNeck dissectionOral cancerSquamous cell carcinomaSquamous cell carcinoma of the head and neck

Identifiers

PMID39681094
PMCPMC11887986

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.