When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck? A systematic review

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• 作者：L. Tang¹ ; Y.Y. Leung² ; ^{mikeyyleung@hku.hk" class="auth_mail" title="E-mail the corresponding author}
• 关键词：head and neck cancer ; oral cancer ; squamous cell carcinoma ; maxillary squamous cell carcinoma ; elective neck dissection ; systematic review
• 刊名：International Journal of Oral and Maxillofacial Surgery
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：45
• 期：11
• 页码：1358-1365
• 全文大小：541 K

文摘

The purpose of this systematic review was to answer the clinical question “When should elective neck dissection be performed in maxillary gingival and alveolar squamous cell carcinoma with a cN0 neck?” A systematic review, designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was conducted by two independent reviewers with three rounds of search and evaluation. Ten studies with 506 patients were included in the final review. The overall risk of cervical metastasis was 23.2% for those who did not receive an elective neck dissection (END), which was 3.4 times higher than that in the END group (6.8%). The 5-year survival rate was higher in those who had an END (80.3%) when compared to those who did not receive an END (67.4%). Overall, 14.1% of the cases with cN0 maxillary squamous cell carcinoma (SCC) presented with positive node(s) in pathological specimens after END. The risk of occult cervical metastasis in a cN0 maxillary SCC case with pathological stage pT1, pT2, pT3, and pT4 was 11.1%, 12.1%, 20%, and 36.1%, respectively. It is therefore concluded that END is recommended in patients with cN0 maxillary SCC, especially in stage T3 or T4 cases.