Hitesh Rajendra Singhavi1, Sudhir Nair2, Manish Mair3, Rachit Mathur4, Arjun Singh4, Ameya Pai4, Akshay Patil5, Deepa Nair4, Pankaj Chaturvedi4. 1. Department of Head and Neck Surgical Oncology, TMH, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, Mumbai, India; Consultant Head & Neck Surgeon, Fortis Hospital, Mulund, Mumbai, India. 2. Department of Head and Neck Surgical Oncology, TMH, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, Mumbai, India. Electronic address: sudhirvr@gmail.com. 3. Department of Head and Neck Surgical Oncology, TMH, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, Mumbai, India; Royal Infirmary Hospital, Leicester, UK. 4. Department of Head and Neck Surgical Oncology, TMH, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, Mumbai, India. 5. Department of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre, Maharashtra, Mumbai, 400012, India.
Abstract
BACKGROUND: Evidence for performing contralateral neck dissection (CND) of recurrent oral cavity squamous cell cancers (OCSCC) is lacking. MATERIAL AND METHODS: This is a retrospective study of 78 consecutive OCSCC having ipsilateral recurrence recorded over five years. We screened 1658 OCSCC patients and selected those patients who underwent CND as part of treatment for ipsilateral recurrence. RESULTS: The median disease-free interval was 32 months. Incidence of contralateral nodal metastasis (CNM) in recurrent OCSCC was 23.1% and of which 14% were occult. The factor significantly influencing CNM was the depth of invasion (DOI) > 10 mm (p < 0.01). In our study, imaging had suboptimal PPV (33%) while it had high NPV (88%) in diagnosing nodal metastasis in recurrent OCSCC. CONCLUSION: DOI is the most important factor predicting CNM in case of ipsilateral primary recurrence. PET-CECT has a high NPV and contralateral neck should be addressed in case of tumours with higher DOI.
BACKGROUND: Evidence for performing contralateral neck dissection (CND) of recurrent oral cavity squamous cell cancers (OCSCC) is lacking. MATERIAL AND METHODS: This is a retrospective study of 78 consecutive OCSCC having ipsilateral recurrence recorded over five years. We screened 1658 OCSCC patients and selected those patients who underwent CND as part of treatment for ipsilateral recurrence. RESULTS: The median disease-free interval was 32 months. Incidence of contralateral nodal metastasis (CNM) in recurrent OCSCC was 23.1% and of which 14% were occult. The factor significantly influencing CNM was the depth of invasion (DOI) > 10 mm (p < 0.01). In our study, imaging had suboptimal PPV (33%) while it had high NPV (88%) in diagnosing nodal metastasis in recurrent OCSCC. CONCLUSION: DOI is the most important factor predicting CNM in case of ipsilateral primary recurrence. PET-CECT has a high NPV and contralateral neck should be addressed in case of tumours with higher DOI.