Prevalence and implications of bilateral and solely contralateral lymph node metastases in oral squamous cell carcinoma.
Bilateral metastases
Contralateral metastases
Lymph node metastasis
Neck dissection
Oral squamous cell carcinoma
Journal
Clinical oral investigations
ISSN: 1436-3771
Titre abrégé: Clin Oral Investig
Pays: Germany
ID NLM: 9707115
Informations de publication
Date de publication:
23 Apr 2024
23 Apr 2024
Historique:
received:
26
02
2024
accepted:
02
04
2024
medline:
23
4
2024
pubmed:
23
4
2024
entrez:
23
4
2024
Statut:
epublish
Résumé
Effective management of neck in oral squamous cell carcinoma (OSCC) is pivotal for oncological outcomes. Although consensus exists for ipsilateral neck dissection (ND), the necessity for contralateral ND remains controversial. This study aimed to assess the prevalence and implications of bilateral/solely contralateral (B/SC) lymph node metastases (LNMs) to determine the need for contralateral elective ND. Additionally, it examined the prevalence and implications of occult B/SC metastases. In a retrospective cohort study, 420 OSCC patients underwent primary surgical treatment following German guidelines at a tertiary center. Preoperative contrast-enhanced computed tomography was conducted, and ND adhered to a standardized approach. Solely contralateral metastases occurred in 0.95% of patients, with bilateral metastases observed in 7.13%. Occult B/SC metastases occurred in 3.81% of the cases. Correlation analysis revealed a statistically significant association between B/SC metastases and higher tumor stages, tumor localization at the upper jaw or floor of the mouth, proximity to the midline, ipsilateral LNMs, and lymphatic invasion (all p < 0.05). Patients with B/SC metastases showed poorer disease-free survival, with statistical significance reached in the bilateral LNMs group (p = 0.010). Similarly, a significant difference was noted in overall survival between patients with bilateral and solely ipsilateral metastases (p = 0.044). B/SC LNMs are rare in patients with OSCC, especially in those who present with clinico-radiologically negative ipsilateral necks. Higher rates of B/SC metastases occur in case of advanced tumors and those localized at the upper jaw or floor of the mouth. Ipsilateral LNMs significantly elevate the risk of contralateral LNMs, tripling the associated risk. These findings provide valuable insights for surgeons considering contralateral ND or extended adjuvant treatment for OSCC patients. However, the absence of high-level evidence from randomized controlled trials impedes the establishment of a definitive standard of care.
Identifiants
pubmed: 38652329
doi: 10.1007/s00784-024-05650-1
pii: 10.1007/s00784-024-05650-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
267Informations de copyright
© 2024. The Author(s).
Références
Moratin J, Horn D, Metzger K, Ristow O, Flechtenmacher C, Engel M et al (2020) Squamous cell carcinoma of the mandible - patterns of metastasis and disease recurrence in dependence of localization and therapy. J Craniomaxillofac Surg 48(12):1158–1163. https://doi.org/10.1016/j.jcms.2020.10.006
doi: 10.1016/j.jcms.2020.10.006
pubmed: 33199211
Ganly I, Patel S, Shah J (2012) Early stage squamous cell cancer of the oral tongue–clinicopathologic features affecting outcome. Cancer 118(1):101–111. https://doi.org/10.1002/cncr.26229
doi: 10.1002/cncr.26229
pubmed: 21717431
Crile G III (1906) On the technique of Operations upon the Head and Neck. Ann Surg 44(6):842–850. https://doi.org/10.1097/00000658-190612000-00003
doi: 10.1097/00000658-190612000-00003
pubmed: 17861894
pmcid: 1414224
Koyfman SA, Ismaila N, Crook D, D’Cruz A, Rodriguez CP, Sher DJ et al (2019) Management of the Neck in squamous cell carcinoma of the oral cavity and oropharynx: ASCO Clinical Practice Guideline. J Clin Oncol 37(20):1753–1774. https://doi.org/10.1200/JCO.18.01921
doi: 10.1200/JCO.18.01921
pubmed: 30811281
pmcid: 7098829
Fan S, Tang QL, Lin YJ, Chen WL, Li JS, Huang ZQ et al (2011) A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma. Int J Oral Sci 3(4):180–191. https://doi.org/10.4248/IJOS11068
doi: 10.4248/IJOS11068
pubmed: 22010576
pmcid: 3469975
Capote-Moreno A, Naval L, Munoz-Guerra MF, Sastre J, Rodriguez-Campo FJ (2010) Prognostic factors influencing contralateral neck lymph node metastases in oral and oropharyngeal carcinoma. J Oral Maxillofac Surg 68(2):268–275. https://doi.org/10.1016/j.joms.2009.09.071
doi: 10.1016/j.joms.2009.09.071
pubmed: 20116694
Koo BS, Lim YC, Lee JS, Choi EC (2006) Management of contralateral N0 neck in oral cavity squamous cell carcinoma. Head Neck 28(10):896–901. https://doi.org/10.1002/hed.20423
doi: 10.1002/hed.20423
pubmed: 16721743
Habib M, Murgasen J, Gao K, Ashford B, Shannon K, Ebrahimi A et al (2016) Contralateral neck failure in lateralized oral squamous cell carcinoma. ANZ J Surg 86(3):188–192. https://doi.org/10.1111/ans.13206
doi: 10.1111/ans.13206
pubmed: 26138827
Lim YC, Lee JS, Koo BS, Kim SH, Kim YH, Choi EC (2006) Treatment of contralateral N0 neck in early squamous cell carcinoma of the oral tongue: elective neck dissection versus observation. Laryngoscope 116(3):461–465. https://doi.org/10.1097/01.mlg.0000195366.91395.9b
doi: 10.1097/01.mlg.0000195366.91395.9b
pubmed: 16540910
Ganly I, Goldstein D, Carlson DL, Patel SG, O’Sullivan B, Lee N et al (2013) Long-term regional control and survival in patients with low-risk, early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: the importance of tumor thickness. Cancer 119(6):1168–1176. https://doi.org/10.1002/cncr.27872
doi: 10.1002/cncr.27872
pubmed: 23184439
Cai H, Zhu Y, Wang C, Zhang Y, Hou J (2020) Neck nodal recurrence and survival of clinical T1-2 N0 oral squamous cell carcinoma in comparison of elective neck dissection versus observation: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 129(4):296–310. https://doi.org/10.1016/j.oooo.2019.10.012
doi: 10.1016/j.oooo.2019.10.012
pubmed: 32107184
D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R et al (2015) Elective versus therapeutic Neck dissection in node-negative oral Cancer. N Engl J Med 373(6):521–529. https://doi.org/10.1056/NEJMoa1506007
doi: 10.1056/NEJMoa1506007
pubmed: 26027881
Struckmeier AK, Eichhorn P, Agaimy A, Buchbender M, Moest T, Lutz R et al (2024) Comparison of the 7th and revised 8th UICC editions (2020) for oral squamous cell carcinoma: how does the reclassification impact staging and survival? Virchows Arch. https://doi.org/10.1007/s00428-023-03727-y
doi: 10.1007/s00428-023-03727-y
pubmed: 38191928
Kowalski LP, Bagietto R, Lara JR, Santos RL, Tagawa EK, Santos IR (1999) Factors influencing contralateral lymph node metastasis from oral carcinoma. Head Neck 21(2):104–110. https://doi.org/10.1002/(sici)1097-0347(199903)21:2<104::aid-hed2>3.0.co;2-l
Fortin A, Couture C, Doucet R, Albert M, Allard J, Tetu B (2001) Does histologic grade have a role in the management of head and neck cancers? J Clin Oncol 19(21):4107–4116. https://doi.org/10.1200/JCO.2001.19.21.4107
doi: 10.1200/JCO.2001.19.21.4107
pubmed: 11689578
Nguyen E, McKenzie J, Clarke R, Lou S, Singh T (2021) The indications for Elective Neck dissection in T1N0M0 oral cavity squamous cell carcinoma. J Oral Maxillofac Surg 79(8):1779–1793. https://doi.org/10.1016/j.joms.2021.01.042
doi: 10.1016/j.joms.2021.01.042
pubmed: 33744243
Remmert S, Rottmann M, Reichenbach M, Sommer K, Friedrich HJ (2001) [Lymph node metastasis in head-neck tumors]. Laryngorhinootologie 80(1):27–35. https://doi.org/10.1055/s-2001-11027
doi: 10.1055/s-2001-11027
pubmed: 11272244
Olzowy B, Tsalemchuk Y, Schotten KJ, Reichel O, Harreus U (2011) Frequency of bilateral cervical metastases in oropharyngeal squamous cell carcinoma: a retrospective analysis of 352 cases after bilateral neck dissection. Head Neck 33(2):239–243. https://doi.org/10.1002/hed.21436
doi: 10.1002/hed.21436
pubmed: 20848445
Arain AA, Rajput MSA, Ansari SA, Mahmood Z, Ahmad AN, Dogar MR et al (2020) Occult nodal metastasis in oral cavity cancers. Cureus 12(11):e11640. https://doi.org/10.7759/cureus.11640
doi: 10.7759/cureus.11640
pubmed: 33376652
pmcid: 7755664
Florke C, Gulses A, Altmann CR, Wiltfang J, Wieker H, Naujokat H (2021) Clinicopathological risk factors for Contralateral Lymph Node Metastases in Intraoral squamous cell carcinoma: a study of 331 cases. Curr Oncol 28(3):1886–1898. https://doi.org/10.3390/curroncol28030175
doi: 10.3390/curroncol28030175
pubmed: 34069011
pmcid: 8161834
Lloyd S, Yu JB, Wilson LD, Judson BL, Decker RH (2012) The prognostic importance of midline involvement in oral tongue cancer. Am J Clin Oncol 35(5):468–473. https://doi.org/10.1097/COC.0b013e3182195619
doi: 10.1097/COC.0b013e3182195619
pubmed: 21701377
pmcid: 3755371
Iype EM, Sebastian P, Mathew A, Balagopal PG, Varghese BT, Thomas S (2008) The role of selective neck dissection (I-III) in the treatment of node negative (N0) neck in oral cancer. Oral Oncol 44(12):1134–1138. https://doi.org/10.1016/j.oraloncology.2008.02.017
doi: 10.1016/j.oraloncology.2008.02.017
pubmed: 18486527
Struckmeier AK, Yekta E, Agaimy A, Kopp M, Buchbender M, Moest T et al (2023) Diagnostic accuracy of contrast-enhanced computed tomography in assessing cervical lymph node status in patients with oral squamous cell carcinoma. J Cancer Res Clin Oncol. https://doi.org/10.1007/s00432-023-05470-y
doi: 10.1007/s00432-023-05470-y
pubmed: 37875746
pmcid: 10657302
Malik A, Hardman JC, Devabalan Y, Nutting C, Bhide S, Harrington K et al (2023) Systematic review and meta-analysis of occult contralateral nodal metastases in patients with oropharyngeal squamous carcinoma undergoing elective neck dissection. Eur J Surg Oncol 49(2):316–322. https://doi.org/10.1016/j.ejso.2022.10.004
doi: 10.1016/j.ejso.2022.10.004
pubmed: 36270881
McGuirt WF Jr., Johnson JT, Myers EN, Rothfield R, Wagner R (1995) Floor of mouth carcinoma. The management of the clinically negative neck. Arch Otolaryngol Head Neck Surg 121(3):278–282. https://doi.org/10.1001/archotol.1995.01890030020004
doi: 10.1001/archotol.1995.01890030020004
pubmed: 7873143
Fakih AR, Rao RS, Borges AM, Patel AR (1989) Elective versus therapeutic neck dissection in early carcinoma of the oral tongue. Am J Surg 158(4):309–313. https://doi.org/10.1016/0002-9610(89)90122-0
doi: 10.1016/0002-9610(89)90122-0
pubmed: 2802032
Struckmeier AK, Buchbender M, Moest T, Lutz R, Agaimy A, Kesting M (2024) Occult metastasis is no burden factor in oral squamous cell carcinoma patients when adhering to a standardized approach in neck dissection. Clin Oral Invest 28(1). https://doi.org/10.1007/s00784-024-05514-8
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