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Cancers 2019, 11(2), 269; https://doi.org/10.3390/cancers11020269

Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma

1
Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan
2
Department of Public Health, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan
3
Department of Surgical Pathology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan
*
Author to whom correspondence should be addressed.
These authors contributed equally to the study.
Received: 1 February 2019 / Revised: 19 February 2019 / Accepted: 20 February 2019 / Published: 25 February 2019
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Abstract

The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p < 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p < 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated. View Full-Text
Keywords: oral squamous cell carcinoma; selective neck dissection; survival; metastatic nodal parameters; pathologically positive nodes oral squamous cell carcinoma; selective neck dissection; survival; metastatic nodal parameters; pathologically positive nodes
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Shimura, S.; Ogi, K.; Miyazaki, A.; Shimizu, S.; Kaneko, T.; Sonoda, T.; Kobayashi, J.; Igarashi, T.; Miyakawa, A.; Hasegawa, T.; Hiratsuka, H. Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma. Cancers 2019, 11, 269.

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