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. 2020 Dec;15(4):519-525.
doi: 10.1016/j.jds.2020.06.002. Epub 2020 Jun 7.

The influence of cervical lymph node number of neck dissection on the prognosis of the early oral cancer patients

Chieh-Yuan Cheng  1   2   3 , Fang-Ju Sun  4 , Chung-Ji Liu  1   2   3
Affiliations

The influence of cervical lymph node number of neck dissection on the prognosis of the early oral cancer patients

Chieh-Yuan Cheng et al. J Dent Sci. 2020 Dec.

Abstract

Background/purpose: The status of neck lymph nodes (LNs) plays an important role in survival of oral cavity cancer. Early stage oral cancer patients are still at a risk for locoregional metastasis. We aimed to determine the number of LNs that needs to be retrieved for adequate diagnosis and treatment of the neck tumor.

Materials and methods: We conducted a retrospective study of 126 oral cavity cancer patients who underwent wide excision and 3 types of neck dissection at MacKay Memorial Hospital, Taiwan. Data from the operative and pathology reports were collected and analyzed. The significant difference was defined as p < 0.05 by SPSS 21.0 and Prizm 5 software.

Results: There was a significant difference between the total retrieved LNs and tumor differentiation and nerve invasion on multivariate analysis. Receiveroperating characteristic (ROC) curve showed significant difference in the total number of neck LNs between the survival and expired groups. The cut-off point was 36.5 nodes. However, there was no difference in survival between supraomohyoid and modified radical neck dissection.

Conclusion: Retrieval of adequate LNs can improve oral cancer survival rates. If total number of neck nodes examined is <37 with poor differentiation and/or nerve invasion, early oral cancer patients with neck dissection have a lower survival rate and are candidates for adjuvant therapy.

Keywords: Lymph nodes number; Oral cancer; Prognosis; Survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Unpaired t test showing no difference in the number of examined neck lymph nodes between the nodal positive and nodal negative oral cancer groups; p = 0.89.
Figure 2
Figure 2
Mann Whitney test showing significant difference in the total examined lymph nodes number between the total survival and total expired groups of pT1, T2N0 oral cancer patients; p = 0.038; 1S: neck level 1 survival group; 1E: neck level 1 expired group; 2S: neck level 2 survival group; 2E: neck level 2 expired group; 3S: neck level 3 survival group; 3E: neck level 3 expired group; 4S: neck level 4 survival group; 4E: neck level 4 expired group; 5S: neck level 5 survival group; 5E: neck level 5 expired group; Total survival: total neck level of the survival group; Total expired: total neck level of the expired group.
Figure 3
Figure 3
Kaplan–Meier curves showing a significant difference in survival between the total retrieved lymph nodes number ≥37 and < 37; p = 0.019.
Figure 4
Figure 4
Unpaired t test showing significant difference in survival and expired between the ND and W&S groups of the T1, T2 N0 oral cancer patients; p = 0.005; ND: neck dissection; W&S: watch-and-see.
See this image and copyright information in PMC

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