Patients With cT1N0M0 Oral Squamous Cell Carcinoma Benefit From Elective Neck Dissection: A SEER-Based Study

Authors: Alimujiang Wushou DDS, MD 1 , Meng Wang MD 1 , Feiluore Yibulayin MD 2 , Lei Feng MD 1 , Meng-meng Lu DDS, MD 1 , Yuan Luo DDS, MD 1 , Hui Liu DDS, MD 1 and Zhi-cheng Yang DDS, MD 1
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  • 1 Department of Oral and Maxillofacial Surgery and Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University;
  • 2 Department of Preventive Medicine, School of Public Health, Shanghai Medical College, Fudan University, Shanghai, China.
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Background: The incidence of oral squamous cell carcinoma (OSCC) is increasing, with an estimated 369,000 new patients each year worldwide. Surgery is the primary treatment modality for early-stage OSCC, but there is scant evidence to prove the value of elective neck dissection (END) for relatively small early-stage OSCC. This study aimed to identify factors predicting survival for patients with clinical stage T1N0M0 (cT1N0M0) OSCC and whether up-front END improved survival. Patients and Methods: Patients with cT1N0M0 OSCC who underwent tumor resection with or without END were identified and extracted from the SEER database. Kaplan-Meier survival analysis was used to assess overall survival and disease-specific survival. Prognostic factors were determined using Cox regression analysis. Results: A total of 5,752 patients with cT1N0M0 OSCC were extracted, of whom 2,194 (38.1%) underwent tumor resection surgery with concurrent END and 3,558 (61.9%) underwent only tumor resection. In a multivariate Cox analysis, a relatively advanced age (>62 years) and relatively high pathologic grade were the significant negative predictors, but married status (hazard ratio, 0.709; P=.006) and undergoing END (hazard ratio, 0.708; P<.001) were identified as significant independent positive factors. Conclusions: Patients with cT1N0M0 OSCC gain significant overall and disease-specific survival benefit from END.

Submitted April 19, 2020; accepted for publication July 30, 2020. Published online January 29, 2021.

Author contributions: Initial research concept: Wang. Study design: Wang, Wushou. Lead investigators for data collection: Wushou, Yibulayin. Data analysis: Wang, Yibulayin, Feng. Spreadsheet data management: Lu, Luo. Clerical support: Liu. Guidance on study revision: Yang. Manuscript preparation and revision for important intellectual content: All authors.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Correspondence: Zhi-cheng Yang, DDS, MD, Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, 356 Beijing East Road, Shanghai 200001, China. Email: zhicheng_yang1998@fudan.edu.cn

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