Oncological Outcome of Node-Positive Oral Squamous Cell Carcinomas Treated With Selective and Comprehensive Neck Dissection.

IF 2.6 3区 生物学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY BioMed Research International Pub Date : 2024-07-11 eCollection Date: 2024-01-01 DOI:10.1155/2024/9543897
Jan Oliver Voss, Lea Freund, Felix Neumann, Kerstin Rubarth, Kilian Kreutzer, Steffen Sander, Evelyn Golembiewski, Friedrich Mrosk, Christian Doll, Carsten Rendenbach, Max Heiland, Steffen Koerdt
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Abstract

Selective neck dissection (SND) is the treatment of choice in patients with oral squamous cell carcinomas (OSCCs) and clinically node-negative necks (cN0). The treatment of patients with positive-staged necks (cN+) includes SND as well as comprehensive neck dissection (CND). The clear benefit of one or the other remains under debate. We aim to address this lack of clarity by analysing patients with OSCC staged with clinically node-positive necks, treated with either CND or SND using a level-by-level approach. This retrospective study included patients diagnosed with OSCC with clinically (cN+) and pathologically (pN+) positive cervical lymph nodes (LNs) with clear neck level categorization during the years 2010-2019. In total, 74 patients were analysed. Cox regression analysis found no significance for the type of ND being an independent risk factor, neither for overall survival (OS) nor for disease-free survival (DFS). Regional recurrence of CND cases (5.77%) was comparable to SND cases (9.09%). For OS, extracapsular spread (ECS) and male sex were identified as independent risk factors with poorer outcome. pT-stage and ECS were found to be independent risk factors for DFS. The results of this study suggest that both CND and SND may be viable treatment options for certain patients with OSCC pN+.

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选择性和全面性颈部切除术治疗结节阳性口腔鳞状细胞癌的肿瘤学结果
选择性颈部切除术(SND)是口腔鳞状细胞癌(OSCC)和临床颈部结节阴性(cN0)患者的首选治疗方法。对颈部结节阳性(cN+)患者的治疗包括 SND 和颈部综合切除术(CND)。目前仍在争论二者的明显优势。我们旨在通过逐级分析临床分期为颈部结节阳性、接受 CND 或 SND 治疗的 OSCC 患者,解决这一不明确的问题。这项回顾性研究纳入了2010-2019年期间诊断为临床(cN+)和病理(pN+)阳性颈部淋巴结(LN)且颈部级别分类明确的OSCC患者。共对 74 名患者进行了分析。Cox回归分析发现,无论是对总生存期(OS)还是无病生存期(DFS)而言,ND类型都不是独立的风险因素。CND病例(5.77%)的区域复发率与SND病例(9.09%)相当。在OS方面,囊外扩散(ECS)和男性被认为是导致较差预后的独立风险因素,而pT分期和ECS被认为是DFS的独立风险因素。本研究结果表明,对于某些 pN+ OSCC 患者,CND 和 SND 都可能是可行的治疗方案。
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来源期刊
BioMed Research International
BioMed Research International BIOTECHNOLOGY & APPLIED MICROBIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
6.70
自引率
0.00%
发文量
1942
审稿时长
19 weeks
期刊介绍: BioMed Research International is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies covering a wide range of subjects in life sciences and medicine. The journal is divided into 55 subject areas.
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