Neck recurrence in clinically node-negative oral cancer: 27-year experience at a single institution

Oral Oncology
Aviram MizrachiIan Ganly

Abstract

Neck failure in patients with oral squamous cell carcinoma (OSCC) carries a poor outcome, yet the management of patients who initially present with clinically node-negative (cN0) neck is not clearly defined. Retrospective review of patients with cN0 OSCC treated at Memorial Sloan Kettering Cancer Center from 1985 to 2012, focusing on rate, pattern and predictors of neck failure, salvage treatment, and survival outcomes. Of 1,302 patients, 806 (62%) underwent elective neck dissection (END) and 496 (38%) had observation. 190 patients (15%) developed neck recurrence. Median follow-up was 58.5 months (range 1-343); 5-year neck recurrence-free survival (NRFS) was 85% and 80% for the END and observation group respectively (p = .06). Patients with neck failure had poorer outcomes than patients without neck failure (5-year overall survival, 37% vs. 74% [p < .001]; disease-specific survival [DSS], 41% vs. 91% [p < .001]). Independent predictors of neck failure were smoking, primary tumor subsite (hard palate and upper gum), and extranodal extension. 87% of patients underwent salvage treatment (END: 81.1%; observation: 94%). Salvage surgery with adjuvant (chemo) radiation had better DSS than surgery alone or nonsurgical salvage. In our c...Continue Reading

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References

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Citations

May 20, 2020·Oral Diseases·Annelies WeckxMatthias Kreppel
Jun 17, 2020·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Mark SinghSteve Thomas
Mar 12, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Deep ChakrabartiShirin Parveen
Aug 17, 2021·The Laryngoscope·Eyal YosefofAviram Mizrachi
Sep 5, 2021·International Journal of Oral and Maxillofacial Surgery·J J WuX Gao

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