When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck? A systematic review.
The purpose of this systematic review was to answer the clinical question "When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck?" A systematic review, designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was conducted by two independent reviewers with three rounds of search and evaluation. Ten studies with 506 patients were included in the final review. The overall risk of cervical metastasis was 23.2% for those who did not receive an elective neck dissection (END), which was 3.4 times higher than that in the END group (6.8%). The 5-year survival rate was higher in those who had an END (80.3%) when compared to those who did not receive an END (67.4%). Overall, 14.1% of the cases with cN0 maxillary squamous cell carcinoma (SCC) presented with positive node(s) in pathological specimens after END. The risk of occult cervical metastasis in a cN0 maxillary SCC case with pathological stage pT1, pT2, pT3, and pT4 was 11.1%, 12.1%, 20%, and 36.1%, respectively. It is therefore concluded that END is recommended in patients with cN0 maxillary SCC, especially in stage T3 or T4 cases.
Oral and Maxillofacial Surgery Unit, School of Dental Sciences, Universiti Sains Malaysia, Malaysia.
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Tang
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong. Electronic address: mikeyyleung@hku.hk.
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Leung
D000539:Alveolar Process / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D005887:Gingival Neoplasms / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008441:Maxillary Neoplasms / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods* / Q000401:mortality; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
elective neck dissection; head and neck cancer; maxillary squamous cell carcinoma; oral cancer; squamous cell carcinoma; systematic review