Management of the clinically N0 neck in early-stage oral squamous cell carcinoma (OSCC). An EACMFS position paper |
| |
| Institution: | 1. Faculty of Dentistry, The University of Sydney, Sydney, New South Wales, Australia;2. Department of Oral Medicine Oral Pathology and Special Care Dentistry, Level 3, Westmead Centre for Oral Health, Westmead Hospital, Westmead, New South Wales, Australia;3. Perth Oral Medicine & Dental Sleep Centre, Perth, Western Australia, Australia; UWA Dental School, University of Western Australia, Perth, Western Australia, Australia;4. Department of Tissue Pathology and Diagnostic Oncology, Level 3, Institute for Clinical Pathology and Medical Research (ICPMR), Pathology West, Westmead Hospital, Westmead, New South Wales, Australia;5. Department of Otolaryngology/Head and Neck Surgery, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia |
| |
| Abstract: | Metastasis of oral squamous cell carcinoma (OSCC) to the cervical lymph nodes has a significant impact on prognosis. Accurate staging of the neck is important in order to deliver appropriate treatment for locoregional control of the disease and for prognosis.The management of the neck in early, low volume disease (clinically T1/T2 oral cavity tumours) has long been debated. The risk of occult nodal involvement in cT1/T2 OSCC is estimated around 20–30%.We describe the natural evolutionary history of OSCC and its patterns of spread and metastasis to the local lymphatic basins. We discuss most published literature and studies on management of the clinically negative neck (cN0). Particular focus is given to prospective randomized trials comparing the outcomes of upfront elective neck dissection against the observational stance, and we summarize the results of the sentinel node biopsy studies.The paper discusses the significance of the primary tumour histological characteristics and specifically the tumour's depth of invasion (DOI) and its impact on predicting nodal metastasis. The DOI has been incorporated in the TNM staging highlighting its significance in aiding the treatment decision making and this is reflected in world-wide oncological guidelines.The critical analysis of all available literature amalgamates the existing evidence in early OSCC and provides recommendations in the management of the clinically N0 neck. |
| |
| Keywords: | Oral cavity Oral squamous cell carcinoma OSCC Lymph node Sentinel node Depth of invasion |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
