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. 2022 Sep 19;12(9):1535.
doi: 10.3390/jpm12091535.

Adequacy of Disease Control by Supraomohyoid Neck Dissection in cT1/T2 Tongue Cancer

Andrea Iandelli  1   2   3 , Filippo Marchi  2   3   4 , An-Chieh Chen  1 , Chi-Kuan Young  5   6 , Chun-Ta Liao  1   6 , Chung-Kan Tsao  4   6 , Chung-Jan Kang  1   6 , Hung-Ming Wang  6   7 , Tung-Chieh Joseph Chang  6   8 , Shiang-Fu Huang  1   9
Affiliations

Adequacy of Disease Control by Supraomohyoid Neck Dissection in cT1/T2 Tongue Cancer

Andrea Iandelli et al. J Pers Med. .

Abstract

Background: Patients affected by oral tongue squamous cell carcinoma (OTSCC) underwent a supraomohyoid neck dissection (SOHND) or modified radical neck dissection (mRND) according to the clinical nodal status (cN0 vs. cN+). We investigate whether the type of neck dissection affects survival with the presence of extranodal extension (ENE) and multiple nodal metastases (MNM).

Methods: We conducted a retrospective study enrolling surgically treated patients affected by cT1/T2 OTSCC and MNM or ENE. The outcomes assessed were: overall survival (OS), disease-free survival (DFS), and neck-control- and metastases-free survival (NC-MFS). Survival curves were plotted by the Kaplan-Meier method and the log-rank test. Furthermore, we conducted a multivariable analysis with the Cox regression model.

Results: We included a total of 565 patients (36% cT1, 64% cT2). Of these, 501 patients underwent a SOHND, and 64 underwent an mRND. A total of 184 patients presented rpN+, with 28.7% of these in the SOHND group and 62.5% of these in the mRND group. We identified no significant differences in OS, DFS, and NC-MFS in the whole pN+ cohort, in the MNM, and the ENE subgroups. In the multivariable analysis, the type of ND did not affect OS and DFS.

Conclusions: Treating cT1-2 N0/+ tongue cancer with SOHND is oncologically safe. ENE and MNM patients do not benefit from an mRND.

Keywords: head and neck cancer; neck dissection; oral cancer; skip metastases; supraomohyoid neck dissection; tongue cancers.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Disease-free survival differences in pN+ patients by types of neck dissection (n = 184, p = 0.51); (B) overall survival differences in pN+ patients by types of neck dissection (p = 0.12). Dotted line indicated the survival time that half of the patients had no events.
Figure 2
Figure 2
(A) Disease-free survival differences in multiple nodal disease by types of neck dissection (n =100, p = 0.52); (B) overall survival differences in multiple nodal disease by types of neck dissection (p = 0.11). Neck-control-distant metastases-free survival in multiple nodal disease by types of neck dissection. Dotted line indicated the survival time that half of the patients had no events.
Figure 3
Figure 3
(A) Disease-free survival differences in extranodal extension+ (ENE+) by types of neck dissection (n = 94, p = 0.44); (B) overall survival differences in extranodal extension+ (ENE+) by types of neck dissection (p = 0.59). Neck-control-distant metastases-free survival in extranodal extension+ (ENE+) by types of neck dissection. Dotted line indicated the survival time that half of the patients had no events.
See this image and copyright information in PMC

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