title: The role of elective neck dissection in early stage buccal cancer.
abstract: OBJECTIVE
  The benefits of elective neck dissection (END) in early-stage tongue cancer have been widely discussed but are still controversial regarding early-stage buccal cancer. In this study, we evaluate the role of END and the treatment outcome in early-stage buccal cancer in an areca-quid endemic area.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  One hundred seventy-three cT1-2N0M0 buccal cancer patients all staged by computed tomography or magnetic resonance imaging were recruited. A total of 151 patients received radical surgery with END, whereas 22 received observation (OBS). Adjuvant radiotherapy with or without chemotherapy was given in selected high-risk patients.
  
  
  RESULTS
  The 5-year overall survival (OS) rates for cT1 lesions and cT2 lesions were 86.14% and 75.45%, respectively (P = .105). In the END group, the occult metastasis rate was 1.8% for cT1 lesions and 10.6% for cT2 lesions (P = .053). The 5-year neck control rate rates (P = .001) and disease-free survival rates (P = .0101) were significantly better in the END group compared to the OBS group but were not significant in OS (P = .689). Eighteen (10.41%) patients developed a second primary tumor (SPT), and five (2.89%) patients developed a third primary tumor. Ninety-four percent of SPTs were located within the oral cavity.
  
  
  CONCLUSIONS
  END was suggested in T1-T2N0 buccal cancer to improve the neck control rate. In patients for whom END is not performed at the time of tumor excision, regular follow-up of neck status is necessary because the metastatic lesions are mostly salvageable and do not influence the OS.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taipei, Taiwan; Head and Neck Oncology Group, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taipei, Taiwan.
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Kang-Hsing
authors.initials: KH
authors.lastname: Fan
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: I-How
authors.initials: IH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology / Q000601:surgery; D019370:Observation; D012189:Retrospective Studies; D013624:Taiwan
keywords: Early stage; buccal cancer; neck dissection; supraomohyoid neck dissection