This work was presented at the 12th Annual Scientific Meeting of the ANZHNS in Sydney, Australia, September 2–4, 2010.
Improved survival with elective neck dissection in thick early-stage oral squamous cell carcinoma†
Article first published online: 7 JUL 2011
Copyright © 2011 Wiley Periodicals, Inc.
Head & Neck
Volume 34, Issue 5, pages 709–716, May 2012
How to Cite
Ebrahimi, A., Ashford, B. G. and Clark, J. R. (2012), Improved survival with elective neck dissection in thick early-stage oral squamous cell carcinoma. Head Neck, 34: 709–716. doi: 10.1002/hed.21809
- Issue published online: 6 APR 2012
- Article first published online: 7 JUL 2011
- Manuscript Accepted: 17 MAR 2011
- oral cancer;
- squamous cell carcinoma;
- head and neck;
- lymph nodes;
- neck dissection
Management of the node–negative neck in T1 to T2 oral squamous cell carcinoma (SCC) remains controversial. The purpose of this study was to determine if elective neck dissection improves outcomes in thick primary tumors since this reflects current practice in most institutions and has not been specifically addressed in the literature.
Retrospective analysis comparing elective neck dissection versus observation in 153 patients with T1 to T2 N0 oral SCC ≥4 mm thick.
On multivariable analysis, elective neck dissection was a significant predictor of improved regional control (hazard ratio [HR], 0.1; p < .001), disease-specific (HR, 0.1; p < .001), and overall survival (HR, 0.3; p = .001). Regional failure accounted for 22% of disease-related deaths in the elective neck dissection group compared to 92% in the observation arm.
Elective neck dissection is associated with a clinically significant survival advantage in thick T1 to T2 oral SCC by reducing the risk of regional failure, and we support its routine application in these patients. © 2011 Wiley Periodicals, Inc. Head Neck, 2012