title: Selective versus comprehensive neck dissection in the treatment of patients with a pathologically node-positive neck with or without microscopic extracapsular spread in oral squamous cell carcinoma.
abstract: The objective of this study was to compare the prognosis and complications between selective neck dissection (SND) and comprehensive neck dissection (CND) for patients with a pathologically node-positive neck in squamous cell carcinoma of the tongue and the floor of the mouth. This was a retrospective cohort study. There was no significant difference between the SND group and the CND group in 3-year neck control rate (86.2% vs. 85.9%, P=0.797) or disease-specific survival (DSS) rate (64.6% vs. 61.9%, P=0.646). Further analyses of the respective 3-year DSS rates in the SND and CND subgroups were as follows: pN1 without extracapsular spread (ECS), 67.7% vs. 72.2%, P=0.851; pN2b without ECS, 64.7% vs. 68.8%, P=0.797; and pN+ with ECS, 57.1% vs. 60.0%, P=0.939. Of note, there were significantly fewer complications in the SND group compared with the CND group (7.3% vs. 20.0%, P=0.032). Multivariate analysis showed that the modality of neck treatment, pN+ status, and microscopic ECS did not serve as independent prognostic factors. SND plus adjuvant radiotherapy is a management strategy of high efficiency and minor morbidity for selected oral cancer patients with a pN+ neck with or without microscopic ECS.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Feng
authors.affiliation: Department of Pathology, School of Stomatology, Peking University, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing, China.
authors.forename: L X
authors.initials: LX
authors.lastname: Niu
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, Beijing, China. Electronic address: guodazuo@sina.com.
authors.forename: C B
authors.initials: CB
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
keywords: complication; comprehensive neck dissection; microscopic extracapsular spread; oral squamous cell carcinoma; prognosis; selective neck dissection