A retrospective analysis of clinical N1 oral squamous cell carcinoma

Objective

To explore the appropriate dissection extent for cN1 oral cancer and to summarize neck treatment outcomes.

Methods

The cases of a series of oral squamous cell carcinoma (OSCC) patients with cN1, who underwent radical resection of the primary site and neck dissection (I-V) as the initial treatment at our institution. The distribution of pathological cervical lymph node metastases was analyzed, and the overall survival (OS), disease- specific survival (DSS) and regional control rate were estimated by the Kaplan–Meier method.

Results

Pathological positive cervical lymph nodes were seen in 19 of the 57 patients. Eleven patients had one positive lymph node (pN1), whereas eight patients had multiple positive lymph nodes (pN2b). The most distal cervical metastasis was at level Ⅰ or Ⅱ in 17 cases, at level Ⅲ in one case, and at level IV in one case. There was no patient with cervical metastasis at level Ⅴ. The 5-year OS was 79.9%, the 5-year DSS was 85.3%, and the 5-year regional control rate was 87.5%.

Conclusions

In conclusion, of the 57 patients diagnosed as cN1 oral cancer, there was no patient with cervical metastasis at level Ⅴ, suggesting that level V dissection can be omitted.