Oral oncology最新文献

英文中文

Clinical significance of post-chemoradiotherapy 2-[18F]FDG PET/CT response in locally advanced nasopharyngeal carcinoma: A real-world study

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107160

Yiwen Mo , Yuan Wei , Liping Liang , Tingfan Wu , Xinling Li , Ruping Li , Wei Fan , Yingying Hu , Xu Zhang

Purpose

To investigate the prognostic value of post-chemoradiotherapy 2-[¹⁸F]FDG PET/CT in locally advanced nasopharyngeal carcinoma (LANPC) and develop an accurate prognostic model based on the 2-[¹⁸F]FDG PET/CT results.

Methods

900 LANPC patients who underwent pretreatment and post-chemoradiotherapy 2-[¹⁸F]FDG PET/CT from May 2014 to August 2022 were included in the study. We divided the patients into two distinct cohorts for the purpose of our study: a training cohort comprising 506 individuals, included from May 2008 to April 2020, and a validation cohort consisting of 394 individuals, included from May 2020 to August 2022. PET/CT were assessed using the improved Deauville score (iDS) system. Cox regression analysis was performed to select candidate variables. A prognostic model was developed by the training cohort, and validated using the independent validation cohort.

Results

Age (HR, 2.262(1.488–3.439); p＜0.001), ECOG (HR, 2.450 (1.395–4.301); p = 0.002), post-treatment EBV DNA level (HR, 2.208 (1.289–3.784); p = 0.004) and iDS {[iDS1-2 vs iDS3-4: HR, 3.781 (1.996–7.163); p＜0.001]; [iDS1-2 vs iDS5: HR, 11.707 (5.884–23.295); p＜0.001]}were independent predictors of OS. A 4-factor prognostic model developed and subsequently validated. This innovative model demonstrated excellent discrimination (C-index: 0.862). The calibration curves revealed a close match between the predicted probabilities and the actual outcomes, and decision curve analysis (DCA) confirmed the nomogram’s utility for guiding clinical decision-making.

Conclusion

Our study validated the predictive value of the iDS system in determining outcome for LANPC. The 4-factor prognostic model, which integrates baseline patient characteristics with iDS, demonstrated good discrimination, agreement, and clinical application potential.

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引用次数: 0

Does identification of determinants that delay adjuvant treatment and discussing the benefits of adjuvant treatment with patients create an impact? 确定延迟辅助治疗的决定因素和与患者讨论辅助治疗的益处会产生影响吗？

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107188

BhanuPrakash Bylapudi, Sasi Krishna Kavutarapu, Nageswara Rao Noothanapati, Mallikarjun Rao

引用次数: 0

SMARCA4 deficient undifferentiated tumor in nasopharynx 鼻咽部缺乏SMARCA4的未分化肿瘤。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107162

Mengting Shi , Xueyuan Chen , Tingting Liu , Shasha Yin , Zhixiong Lin

引用次数: 0

Undifferentiated small round cell sarcoma of the parapharyngeal space in a 4.5-year-old patient:A rare case report 一例4.5岁患者咽旁间隙未分化小圆细胞肉瘤：罕见病例报告。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107184

Lei Wang, Xinmei Kang

This case report describes a 4.5-year-old girl diagnosed with a rare Undifferentiated Small Round Cell Sarcoma (USRCS) originating in the parapharyngeal space with multiple lung metastases. Diagnostic workups, including imaging, immunohistochemistry, and genetic sequencing, identified the tumor as an unclassified subtype of USRCS. The patient was treated with the Ewing sarcoma chemotherapy regimen, alternating between VDC (vincristine + doxorubicin + cyclophosphamide) and IE (ifosfamide + etoposide), in combination with bevacizumab. The tumor achieved complete remission, and no recurrence has been observed during follow-up.

这个病例报告描述了一个4.5岁的女孩，被诊断为一种罕见的未分化小圆细胞肉瘤（USRCS），起源于咽旁间隙，并伴有多发肺转移。诊断检查，包括影像学、免疫组织化学和基因测序，确定该肿瘤为USRCS的未分类亚型。患者接受尤文氏肉瘤化疗方案，VDC（长春新碱+阿霉素+环磷酰胺）和IE（异环磷酰胺+依托泊苷）交替治疗，联合贝伐单抗。肿瘤完全缓解，随访期间未见复发。

引用次数: 0

Circulating tumor DNA determines induction chemotherapy response in HPV associated oropharyngeal squamous cell carcinoma: A pilot study 循环肿瘤DNA决定了HPV相关口咽鳞状细胞癌的诱导化疗反应：一项初步研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107179

Zachary M. Huttinger , Emile Gogineni , Sujith Baliga , Dukagjin M. Blakaj , Priyanka Bhateja , Marcelo Bonomi , Stephen Y. Kang , Matthew O. Old , Nolan B. Seim , Kyle K. VanKoevering , Amit Agrawal , Enver Ozer , James W. Rocco , Catherine T. Haring

Background

Induction chemotherapy (IC) followed by chemoradiation (CRT) is one treatment approach for patients with locoregionally advanced oropharyngeal squamous cell carcinoma (OPSCC) associated with human papillomavirus (HPV). This pilot study aimed to assess whether a circulating tumor (ct) DNA assay outperforms PET-CT in assessing treatment response in patients with HPV + OPSCC treated with induction chemotherapy (IC) followed by chemoradiation (CRT).

Materials and methods

Patients treated with IC and definitive CRT for HPV + OPSCC were included. HPV ctDNA and PET-CT were performed pre-treatment, 2–3 weeks after IC and 3 months after CRT. CtDNA levels were correlated with tumor volumes. Post-IC and post- CRT ctDNA levels were correlated post-induction and post-treatment imaging responses.

Results

Seventeen patients were included. Baseline ctDNA levels correlated with volume of primary tumor (R2 = 0.33, p = 0.02), but did not correlate with nodal volumes (R2 = 0.01, p = 0.7) or total disease burden (R2 = 0.02, p = 0.6). After IC, 5.9 % (1/17) of patients had complete response by PET- CT, whereas 52.9 % (9/17) had complete molecular response by ctDNA testing. After completion of CRT, 76.5 % (13/17) patients had complete clinical response to treatment. Of patients who had ctDNA clearance after IC, 88.9 % (8/9) remained disease free after definitive CRT, whereas one had progressive disease diagnosed by both imaging and ctDNA. HPV ctDNA clearance after IC predicted disease control after CRT more strongly than PET-CT IC response (61.5 % (8/13) vs 7.7 % (1/13), p = 0.01).

Conclusions

HPV ctDNA clearance following IC outperforms standard imaging in assessing response and may help identify patients with favorable prognosis.

背景：诱导化疗（IC）后放化疗（CRT）是局部区域晚期口咽鳞状细胞癌（OPSCC）伴人乳头瘤病毒（HPV）患者的一种治疗方法。这项初步研究旨在评估循环肿瘤（ct） DNA测定在评估HPV + OPSCC患者接受诱导化疗（IC）和放化疗（CRT）治疗的治疗反应方面是否优于PET-CT。材料和方法：纳入接受IC和最终CRT治疗的HPV + OPSCC患者。治疗前、IC后2 ~ 3周、CRT后3个月分别进行HPV ctDNA和PET-CT检查。CtDNA水平与肿瘤体积相关。诱导后和治疗后的成像反应与ic后和CRT后的ctDNA水平相关。结果：纳入17例患者。基线ctDNA水平与原发肿瘤体积相关（R2 = 0.33, p = 0.02），但与淋巴结体积（R2 = 0.01, p = 0.7）或总疾病负担无关（R2 = 0.02, p = 0.6）。IC后，5.9%（1/17）的患者PET- CT完全缓解，而52.9%（9/17）的患者ctDNA检测完全缓解。完成CRT后，76.5%（13/17）的患者对治疗有完全的临床反应。在IC后ctDNA清除的患者中，88.9%（8/9）在最终CRT后仍无疾病，而1例通过成像和ctDNA诊断为进展性疾病。HPV ctDNA清除率比PET-CT IC反应更能预测CRT后疾病控制(61.5% （8/13)vs 7.7% (1/13), p = 0.01）。结论：IC后HPV ctDNA清除率在评估疗效方面优于标准影像学，可能有助于识别预后良好的患者。

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引用次数: 0

A rare case of a dormant malignancy in long-standing tongue ulceration 一例罕见的潜伏恶性肿瘤在长期舌溃疡。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107173

Aparna Ganesan, Vineeth Kumar, Balasubramanian Krishnan

引用次数: 0

Diagnosis of lymph node metastasis in oral squamous cell carcinoma by an MRI-based deep learning model 基于mri的深度学习模型诊断口腔鳞状细胞癌淋巴结转移。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107165

Le Yang , Sien Zhang , Jinsong Li , Chongjin Feng , Lijun Zhu , Jingyuan Li , Lisong Lin , Xiaozhi Lv , Kai Su , Xiaomei Lao , Jufeng Chen , Wei Cao , Siyi Li , Hongyi Tang , Xueying Chen , Lizhong Liang , Wei Shang , Zhongyi Cao , Fangsong Qiu , Jun Li , Yujie Liang

Background

Cervical lymph node metastasis (LNM) is a well-established poor prognosticator of oral squamous cell carcinoma (OSCC), in which occult metastasis is a subtype that makes prediction challenging. Here, we developed and validated a deep learning (DL) model using magnetic resonance imaging (MRI) for the identification of LNM in OSCC patients.

Methods

This retrospective diagnostic study developed a three-stage DL model by 45,664 preoperative MRI images from 723 patients in 10 Chinese hospitals between January 2015 and October 2020. It was comprehensively processed from training (8:2), multicenter external validation to reader study. The performance of the DL model was accessed and compared with general and specialized radiologists.

Results

LNM was found in 36.51% of all patients, and the occult metastasis rate was 16.45%. The three-stage DL model together with a random forest classifier achieved the performance in identification of LNM with areas under curve (AUC) of 0.97 (0.93–0.99) in training cohort and AUC of 0.81 (0.74–0.86) in external validation cohorts. The models can reduce the occult metastasis rate up to 89.50% and add more benefit in guiding neck dissection in cN0 patients. DL models tied or exceeded average performance relative to both general and specialized radiologists.

Conclusion

Our three-stage DL model based on MRI with three-dimensional sequences was beneficial in detecting LNM and reducing the occult metastasis rate of OSCC patients.

背景：宫颈淋巴结转移（LNM）是口腔鳞状细胞癌（OSCC）的一个公认的不良预后指标，其中隐匿性转移是一个亚型，使得预测具有挑战性。在这里，我们开发并验证了一种使用磁共振成像（MRI）识别OSCC患者LNM的深度学习（DL）模型。方法：本回顾性诊断研究通过2015年1月至2020年10月中国10家医院723例患者的45664张术前MRI图像建立了三级DL模型。从训练（8:2）、多中心外部验证到读者研究进行了全面的处理。对DL模型的性能进行了访问，并与普通和专业放射科医生进行了比较。结果：LNM发生率为36.51%，隐匿转移率为16.45%。三阶段深度学习模型结合随机森林分类器对LNM的识别效果良好，训练队列的曲线下面积（AUC）为0.97(0.93-0.99)，外部验证队列的AUC为0.81（0.74-0.86）。该模型可使cN0患者的隐匿转移率降低89.50%，为指导颈部清扫增加了更多的益处。DL模型与普通和专业放射科医生的平均表现持平或超过平均水平。结论：基于MRI三维序列的三期深度转移模型有助于发现淋巴结转移，降低OSCC患者的隐性转移率。

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引用次数: 0

The role of ctDNA from liquid biopsy in predicting survival outcomes in HPV-negative head and neck cancer: A meta-analysis 液体活检中的ctDNA在预测HPV阴性头颈癌患者生存结果中的作用：荟萃分析

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107148

Nivedita Kaorey , Kyle Dickinson , Venkata Ramana Agnihotram , Anthony Zeitouni , Nader Sadeghi , Julia V. Burnier

The incidence of head and neck cancer (HNC) is on the rise, making it a significant clinical challenge. Human papillomavirus (HPV)-related and HPV-negative HNC exhibit distinct etiopathogenesis and prognoses, requiring targeted approaches for effective management. Conventional tissue biopsies are essential for confirming the diagnosis and locating solid tumors. However, they have limitations in detecting microscopic disease, tracking treatment response, and capturing the dynamic heterogeneity of the mutational profile within the tumor. Liquid biopsy using circulating tumor DNA (ctDNA) analysis has emerged as a promising non-invasive tool to overcome the drawbacks of conventional biopsy for comprehensive molecular profiling.

This meta-analysis aims to colligate available evidence on the clinical utility of ctDNA analysis in predicting survival outcomes, specifically in HPV-negative HNC. Our systematic search of six electronic databases identified eight publications (N = 886 patients) meeting the inclusion criteria. The included studies reported data from HPV-negative HNC patients, employing ctDNA analysis to report survival outcomes. Our findings reveal a significant association between mutation or methylation in ctDNA and worsened survival outcomes in HPV-negative HNC cases. The presence of ctDNA mutations in TP53 and methylation of SEPT9 and SHOX2 was linked to reduced overall survival, disease-free survival, and progression-free survival. Subgroup analyses demonstrated consistent associations across different survival outcomes, ctDNA detection methods, and blood collection tubes used.

Our study underscores the need for future research endeavors prioritizing larger, well-designed prospective studies with standardized methodologies to further elucidate the role of ctDNA analysis in guiding personalized treatment approaches and optimizing patient care in this specific HNC cohort.

头颈癌（HNC）的发病率呈上升趋势，使其成为一个重大的临床挑战。人乳头瘤病毒（HPV）相关和HPV阴性HNC表现出不同的发病机制和预后，需要有针对性的方法进行有效的管理。常规组织活检是确认诊断和定位实体瘤的必要条件。然而，它们在检测显微疾病、跟踪治疗反应和捕获肿瘤内突变谱的动态异质性方面存在局限性。使用循环肿瘤DNA （ctDNA）分析的液体活检已经成为一种有前途的非侵入性工具，以克服常规活检的缺点进行全面的分子分析。本荟萃分析旨在综合ctDNA分析在预测生存结果方面的临床应用的现有证据，特别是在hpv阴性HNC中。我们系统检索了6个电子数据库，确定了8篇出版物（N = 886例患者）符合纳入标准。纳入的研究报告了hpv阴性HNC患者的数据，采用ctDNA分析报告生存结果。我们的研究结果显示，在hpv阴性HNC病例中，ctDNA突变或甲基化与生存结果恶化之间存在显著关联。TP53中ctDNA突变的存在以及SEPT9和SHOX2的甲基化与总生存期、无病生存期和无进展生存期的降低有关。亚组分析表明，不同的生存结果、ctDNA检测方法和使用的采血管之间存在一致的关联。我们的研究强调了未来的研究需要优先考虑更大的、精心设计的前瞻性研究和标准化的方法，以进一步阐明ctDNA分析在指导个性化治疗方法和优化这一特定HNC队列患者护理方面的作用。

{"title":"The role of ctDNA from liquid biopsy in predicting survival outcomes in HPV-negative head and neck cancer: A meta-analysis","authors":"Nivedita Kaorey , Kyle Dickinson , Venkata Ramana Agnihotram , Anthony Zeitouni , Nader Sadeghi , Julia V. Burnier","doi":"10.1016/j.oraloncology.2024.107148","DOIUrl":"10.1016/j.oraloncology.2024.107148","url":null,"abstract":"<div><div>The incidence of head and neck cancer (HNC) is on the rise, making it a significant clinical challenge. Human papillomavirus (HPV)-related and HPV-negative HNC exhibit distinct etiopathogenesis and prognoses, requiring targeted approaches for effective management. Conventional tissue biopsies are essential for confirming the diagnosis and locating solid tumors. However, they have limitations in detecting microscopic disease, tracking treatment response, and capturing the dynamic heterogeneity of the mutational profile within the tumor. Liquid biopsy using circulating tumor DNA (ctDNA) analysis has emerged as a promising non-invasive tool to overcome the drawbacks of conventional biopsy for comprehensive molecular profiling.</div><div>This <em>meta</em>-analysis aims to colligate available evidence on the clinical utility of ctDNA analysis in predicting survival outcomes, specifically in HPV-negative HNC. Our systematic search of six electronic databases identified eight publications (N = 886 patients) meeting the inclusion criteria. The included studies reported data from HPV-negative HNC patients, employing ctDNA analysis to report survival outcomes. Our findings reveal a significant association between mutation or methylation in ctDNA and worsened survival outcomes in HPV-negative HNC cases. The presence of ctDNA mutations in <em>TP53</em> and methylation of <em>SEPT9</em> and <em>SHOX2</em> was linked to reduced overall survival, disease-free survival, and progression-free survival. Subgroup analyses demonstrated consistent associations across different survival outcomes, ctDNA detection methods, and blood collection tubes used.</div><div>Our study underscores the need for future research endeavors prioritizing larger, well-designed prospective studies with standardized methodologies to further elucidate the role of ctDNA analysis in guiding personalized treatment approaches and optimizing patient care in this specific HNC cohort.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"161 ","pages":"Article 107148"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Histological and genetic criteria define a clinically relevant subgroup of HPV-positive oropharyngeal carcinoma

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2025.107209

Malte Suchan , Nora Wuerdemann , Steffen Wagner , Christine Langer , Christoph Arens , Jannik Johannsen , Johanna Prinz , Shachi Jenny Sharma , Arthur Charpentier , Marcel Mayer , Charlotte Klasen , Philipp Zimmermann , Hans Eckel , Christopher Kopp , Christian U. Huebbers , Sebastian Klein , Janna Siemanowski , Jörn Meinel , Jens Peter Klussmann , Alexander Quaas , Christoph Arolt

Introduction

Subgroups with a poorer prognosis exist among patients with human papillomavirus positive oropharyngeal squamous cell carcinoma (HPV-positive OPSCC). This study aims to identify histological and genetic differences within HPV-positive OPSCC and correlate these findings with patient outcomes.

Methods

The study included 102 OPSCC patients, all tested positive for high-risk HPV DNA and p16INK4a expression. Based on histomorphological classification (HPV Prediction Classification, HPV PC), all cases were categorized as either classic HPV-positive OPSCC (cHPV) or non-classic HPV-positive OPSCC (non-cHPV). Next-generation sequencing (NGS) of selected genes was performed on 55 tumor samples, correlating results with morphological status and survival.

Results

Of all cases, 49 % (n = 50/102) were categorized as non-cHPV, histomorphologically resembling HPV-negative OPSCC, and showed significantly poorer overall survival (p = 0.004) and five-year survival rate (5YS: 83.9 % vs. 58.4 %). Multivariate analyses identified HPV PC as an independent prognostic marker (p = 0.027). NGS revealed loss-of-Function (LOF) mutations in TP53 in three non-cHPV samples. Additionally, PIK3CA/PTEN mutations were found in 35.7 % (10/28) of non-cHPV cases. The cumulative burden of gene mutations was higher in the non-cHPV subgroup compared to the cHPV subgroup (n = 53, p = 0.1).

Conclusion

HPV PC distinguished two histomorphological subgroups within HPV-positive OPSCCs: cHPV with excellent prognosis and non-cHPV with poorer overall survival. Non-cHPV tumors also exhibited higher overall mutation rates, notably LOF-TP53 and PIK3CA/PTEN mutations. These morphological subtypes, along with their corresponding mutational profiles, warrant further investigation as potential biomarkers for de-escalation intervention trials.

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引用次数: 0

Omitting elective neck dissection in cT1/2N0 oral squamous cell carcinoma with sentinel lymph node metastasis: A prospective study 有前哨淋巴结转移的cT1/2N0口腔鳞状细胞癌省略选择性颈部清扫：一项前瞻性研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.oraloncology.2024.107149

Qigen Fang , Junhui Yuan , Xu Zhang , Liyuan Dai , Ruihua Luo , Tao Huang

Objective

To examine the distribution of non-sentinel lymph nodes (SLNs) and to determine the feasibility of omitting elective neck dissection (END) in cases of cT1/2N0 oral cancer presenting with SLN metastasis.

Methods

A prospective cohort of patients with cT1/2N0 oral cancer underwent SLN biopsy using a γ-probe alongside methylene blue staining, followed by subsequent END. The primary outcome variable was non-SLN metastasis, with its predictors evaluated through logistic regression analysis.

Results

A total of 200 patients with detectable SLNs were analyzed. Logistic regression revealed a significant odds ratio of 4.28 [95 % confidence interval: 2.11–14.56] for predicting non-SLN metastasis when comparing a depth of invasion greater than 4.0 mm to a DOI of 4.0 mm or less. Among the six cases of non-SLN metastasis, three patients with negative SLN biopsy results exhibited metastasis; one was found in ipsilateral level V and two in contralateral level Ib. In contrast, all three patients with positive SLN biopsy results had a DOI surpassing 4.0 mm, presenting with at least two positive SLNs. Non-SLN metastasis was detected in ipsilateral level III for one patient and at level IV for two others.

Conclusion

END may be judiciously omitted in cases where only one positive SLN is identified in early-stage oral cancer with a depth of invasion of ≤ 4.0 mm.

目的：探讨非前哨淋巴结（SLN）的分布，探讨在cT1/2N0口腔癌合并SLN转移的病例中省略选择性颈部清扫（END）的可行性。方法：对cT1/2N0口腔癌患者进行前瞻性队列研究，使用γ-探针和亚甲基蓝染色进行SLN活检，随后进行END。主要结局变量为非sln转移，其预测因素通过logistic回归分析评估。结果：共分析200例可检出sln的患者。Logistic回归显示，当比较浸润深度大于4.0 mm与DOI小于或等于4.0 mm时，预测非sln转移的优势比为4.28[95%置信区间：2.11-14.56]。在6例非SLN转移病例中，3例SLN活检结果阴性的患者出现转移；1例在同侧V层，2例在对侧Ib层。相比之下，所有3例SLN活检结果阳性的患者DOI均超过4.0 mm，至少有2例SLN阳性。一名患者在同侧III级发现非sln转移，另外两名患者在IV级发现非sln转移。结论：在浸润深度≤4.0 mm的早期口腔癌中，如果只发现一个SLN阳性，则可以明智地省略END。

{"title":"Omitting elective neck dissection in cT1/2N0 oral squamous cell carcinoma with sentinel lymph node metastasis: A prospective study","authors":"Qigen Fang , Junhui Yuan , Xu Zhang , Liyuan Dai , Ruihua Luo , Tao Huang","doi":"10.1016/j.oraloncology.2024.107149","DOIUrl":"10.1016/j.oraloncology.2024.107149","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the distribution of non-sentinel lymph nodes (SLNs) and to determine the feasibility of omitting elective neck dissection (END) in cases of cT1/2N0 oral cancer presenting with SLN metastasis.</div></div><div><h3>Methods</h3><div>A prospective cohort of patients with cT1/2N0 oral cancer underwent SLN biopsy using a γ-probe alongside methylene blue staining, followed by subsequent END. The primary outcome variable was non-SLN metastasis, with its predictors evaluated through logistic regression analysis.</div></div><div><h3>Results</h3><div>A total of 200 patients with detectable SLNs were analyzed. Logistic regression revealed a significant odds ratio of 4.28 [95 % confidence interval: 2.11–14.56] for predicting non-SLN metastasis when comparing a depth of invasion greater than 4.0 mm to a DOI of 4.0 mm or less. Among the six cases of non-SLN metastasis, three patients with negative SLN biopsy results exhibited metastasis; one was found in ipsilateral level V and two in contralateral level Ib. In contrast, all three patients with positive SLN biopsy results had a DOI surpassing 4.0 mm, presenting with at least two positive SLNs. Non-SLN metastasis was detected in ipsilateral level III for one patient and at level IV for two others.</div></div><div><h3>Conclusion</h3><div>END may be judiciously omitted in cases where only one positive SLN is identified in early-stage oral cancer with a depth of invasion of ≤ 4.0 mm.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"161 ","pages":"Article 107149"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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