Kevin Y Zhan1, Patrick F Morgan2, David M Neskey2, Joanne J Kim3, Andrew T Huang4, Elizabeth Garrett-Mayer3, Terry A Day2. 1. Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. 2. Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina. 3. Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina. 4. Department of Otolaryngology - Head & Neck Surgery, Baylor College of Medicine, Houston, Texas.
Abstract
BACKGROUND: Nodal disease predicts survival in oral cavity squamous cell carcinoma (SCC). Currently, no large studies on predictors of occult nodal disease in cT1N0 oral cavity SCC exist. METHODS: The National Cancer Database (NCDB) review for cT1N0 oral cavity SCC with surgical resection and elective neck dissection (END). RESULTS: The number of patients found with occult nodal disease was 2623 (15.1%). In multivariable regression, female sex and tumor differentiation predict occult nodal disease. Occult nodal disease incidence was 5.9% in well-differentiated tumors, 17.4% in moderately differentiated tumors, and 28.5% in poorly differentiated tumor (P < .001). Women with oral tongue tumors had higher occult nodal disease (19.1%) than men (12%; P = .001). Adjusted odds ratios (aORs) for occult nodal disease in women were: aOR 1.26; 95% confidence interval (CI) 1.01-1.59; P = .045; moderately differentiated aOR 3.52; 95% CI 2.47-5.01; P < .001; and poorly differentiated aOR 6.25; 95% CI 4.17-9.38; P < .001. CONCLUSION: Sex and tumor differentiation significantly predict occult nodal disease. END is recommended for all moderately and poorly differentiated cT1N0 oral cavity SCC, regardless of the depth of invasion. One can consider not performing END in well-differentiated tumors.
BACKGROUND: Nodal disease predicts survival in oral cavity squamous cell carcinoma (SCC). Currently, no large studies on predictors of occult nodal disease in cT1N0 oral cavity SCC exist. METHODS: The National Cancer Database (NCDB) review for cT1N0 oral cavity SCC with surgical resection and elective neck dissection (END). RESULTS: The number of patients found with occult nodal disease was 2623 (15.1%). In multivariable regression, female sex and tumor differentiation predict occult nodal disease. Occult nodal disease incidence was 5.9% in well-differentiated tumors, 17.4% in moderately differentiated tumors, and 28.5% in poorly differentiated tumor (P < .001). Women with oral tongue tumors had higher occult nodal disease (19.1%) than men (12%; P = .001). Adjusted odds ratios (aORs) for occult nodal disease in women were: aOR 1.26; 95% confidence interval (CI) 1.01-1.59; P = .045; moderately differentiated aOR 3.52; 95% CI 2.47-5.01; P < .001; and poorly differentiated aOR 6.25; 95% CI 4.17-9.38; P < .001. CONCLUSION: Sex and tumor differentiation significantly predict occult nodal disease. END is recommended for all moderately and poorly differentiated cT1N0 oral cavity SCC, regardless of the depth of invasion. One can consider not performing END in well-differentiated tumors.
Authors: Chandler J Rygalski; Songzhu Zhao; Antoine Eskander; Kevin Y Zhan; Edmund A Mroz; Guy Brock; Dustin A Silverman; Dukagjin Blakaj; Marcelo R Bonomi; Ricardo L Carrau; Matthew O Old; James W Rocco; Nolan B Seim; Sidharth V Puram; Stephen Y Kang Journal: Ann Surg Oncol Date: 2020-11-13 Impact factor: 5.344
Authors: Iain L Hutchison; Fran Ridout; Sharon M Y Cheung; Allan Hackshaw; Neil Shah; Peter Hardee; Christian Surwald; Janavikulam Thiruchelvam; Leo Cheng; Tim K Mellor; Peter A Brennan; Andrew J Baldwin; Richard J Shaw; Wayne Halfpenny; Martin Danford; Simon Whitley; Graham Smith; Malcolm W Bailey; Bob Woodwards; Manu Patel; Joseph McManners; Chi-Hwa Chan; Andrew Burns; Prav Praveen; Andrew C Camilleri; Chris Avery; Graham Putnam; Keith Jones; Keith Webster; William P Smith; Colin Edge; Iain McVicar; Nick Grew; Stuart Hislop; Nicholas Kalavrezos; Ian C Martin Journal: Br J Cancer Date: 2019-10-15 Impact factor: 7.640