Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma?
ObjectiveThe depth of invasion (DOI) is considered an independent risk factor for occult lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC). It is used to decide whether an elective neck dissection (END) is indicated in the case of a clinically negative neck for early stage carcino...
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.628320/full |
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| author | Yassine Aaboubout Yassine Aaboubout Quincy M. van der Toom Maria A. J. de Ridder Maria J. De Herdt Berdine van der Steen Cornelia G. F. van Lanschot Elisa M. Barroso Elisa M. Barroso Elisa M. Barroso Maria R. Nunes Soares Maria R. Nunes Soares Ivo ten Hove Hetty Mast Roeland W. H. Smits Aniel Sewnaik Dominiek A. Monserez Stijn Keereweer Peter J. Caspers Robert J. Baatenburg de Jong Tom C. Bakker Schut Gerwin J. Puppels José A. Hardillo Senada Koljenović |
| author_facet | Yassine Aaboubout Yassine Aaboubout Quincy M. van der Toom Maria A. J. de Ridder Maria J. De Herdt Berdine van der Steen Cornelia G. F. van Lanschot Elisa M. Barroso Elisa M. Barroso Elisa M. Barroso Maria R. Nunes Soares Maria R. Nunes Soares Ivo ten Hove Hetty Mast Roeland W. H. Smits Aniel Sewnaik Dominiek A. Monserez Stijn Keereweer Peter J. Caspers Robert J. Baatenburg de Jong Tom C. Bakker Schut Gerwin J. Puppels José A. Hardillo Senada Koljenović |
| author_sort | Yassine Aaboubout |
| collection | DOAJ |
| description | ObjectiveThe depth of invasion (DOI) is considered an independent risk factor for occult lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC). It is used to decide whether an elective neck dissection (END) is indicated in the case of a clinically negative neck for early stage carcinoma (pT1/pT2). However, there is no consensus on the cut-off value of the DOI for performing an END. The aim of this study was to determine a cut-off value for clinical decision making on END, by assessing the association of the DOI and the risk of occult lymph node metastasis in early OCSCC.MethodsA retrospective cohort study was conducted at the Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Patients surgically treated for pT1/pT2 OCSCC between 2006 and 2012 were included. For all cases, the DOI was measured according to the 8th edition of the American Joint Committee on Cancer guideline. Patient characteristics, tumor characteristics (pTN, differentiation grade, perineural invasion, and lymphovascular invasion), treatment modality (END or watchful waiting), and 5-year follow-up (local recurrence, regional recurrence, and distant metastasis) were obtained from patient files.ResultsA total of 222 patients were included, 117 pT1 and 105 pT2. Occult lymph node metastasis was found in 39 of the 166 patients who received END. Univariate logistic regression analysis showed DOI to be a significant predictor for occult lymph node metastasis (odds ratio (OR) = 1.3 per mm DOI; 95% CI: 1.1–1.5, p = 0.001). At a DOI of 4.3 mm the risk of occult lymph node metastasis was >20% (all subsites combined).ConclusionThe DOI is a significant predictor for occult lymph node metastasis in early stage oral carcinoma. A NPV of 81% was found at a DOI cut-off value of 4 mm. Therefore, an END should be performed if the DOI is >4 mm. |
| first_indexed | 2024-12-14T15:36:55Z |
| format | Article |
| id | doaj.art-747aa41bb148456e9bc6861b26397bd8 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-14T15:36:55Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-747aa41bb148456e9bc6861b26397bd82022-12-21T22:55:43ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-03-011110.3389/fonc.2021.628320628320Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma?Yassine Aaboubout0Yassine Aaboubout1Quincy M. van der Toom2Maria A. J. de Ridder3Maria J. De Herdt4Berdine van der Steen5Cornelia G. F. van Lanschot6Elisa M. Barroso7Elisa M. Barroso8Elisa M. Barroso9Maria R. Nunes Soares10Maria R. Nunes Soares11Ivo ten Hove12Hetty Mast13Roeland W. H. Smits14Aniel Sewnaik15Dominiek A. Monserez16Stijn Keereweer17Peter J. Caspers18Robert J. Baatenburg de Jong19Tom C. Bakker Schut20Gerwin J. Puppels21José A. Hardillo22Senada Koljenović23Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Medical informatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsDepartment of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, NetherlandsObjectiveThe depth of invasion (DOI) is considered an independent risk factor for occult lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC). It is used to decide whether an elective neck dissection (END) is indicated in the case of a clinically negative neck for early stage carcinoma (pT1/pT2). However, there is no consensus on the cut-off value of the DOI for performing an END. The aim of this study was to determine a cut-off value for clinical decision making on END, by assessing the association of the DOI and the risk of occult lymph node metastasis in early OCSCC.MethodsA retrospective cohort study was conducted at the Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Patients surgically treated for pT1/pT2 OCSCC between 2006 and 2012 were included. For all cases, the DOI was measured according to the 8th edition of the American Joint Committee on Cancer guideline. Patient characteristics, tumor characteristics (pTN, differentiation grade, perineural invasion, and lymphovascular invasion), treatment modality (END or watchful waiting), and 5-year follow-up (local recurrence, regional recurrence, and distant metastasis) were obtained from patient files.ResultsA total of 222 patients were included, 117 pT1 and 105 pT2. Occult lymph node metastasis was found in 39 of the 166 patients who received END. Univariate logistic regression analysis showed DOI to be a significant predictor for occult lymph node metastasis (odds ratio (OR) = 1.3 per mm DOI; 95% CI: 1.1–1.5, p = 0.001). At a DOI of 4.3 mm the risk of occult lymph node metastasis was >20% (all subsites combined).ConclusionThe DOI is a significant predictor for occult lymph node metastasis in early stage oral carcinoma. A NPV of 81% was found at a DOI cut-off value of 4 mm. Therefore, an END should be performed if the DOI is >4 mm.https://www.frontiersin.org/articles/10.3389/fonc.2021.628320/fulloral cancersquamous cell carcinoma of head and neckdepth of invasionoccult metastasiselective neck dissection |
| spellingShingle | Yassine Aaboubout Yassine Aaboubout Quincy M. van der Toom Maria A. J. de Ridder Maria J. De Herdt Berdine van der Steen Cornelia G. F. van Lanschot Elisa M. Barroso Elisa M. Barroso Elisa M. Barroso Maria R. Nunes Soares Maria R. Nunes Soares Ivo ten Hove Hetty Mast Roeland W. H. Smits Aniel Sewnaik Dominiek A. Monserez Stijn Keereweer Peter J. Caspers Robert J. Baatenburg de Jong Tom C. Bakker Schut Gerwin J. Puppels José A. Hardillo Senada Koljenović Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? Frontiers in Oncology oral cancer squamous cell carcinoma of head and neck depth of invasion occult metastasis elective neck dissection |
| title | Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? |
| title_full | Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? |
| title_fullStr | Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? |
| title_full_unstemmed | Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? |
| title_short | Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? |
| title_sort | is the depth of invasion a marker for elective neck dissection in early oral squamous cell carcinoma |
| topic | oral cancer squamous cell carcinoma of head and neck depth of invasion occult metastasis elective neck dissection |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.628320/full |
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