Depth of invasion in early stage oral cavity squamous cell carcinoma: The optimal cut-off value for elective neck dissection
•Depth of invasion (DOI) is associated with lymph node metastasis in oral cancer (OC).•The AJCC (8th edition) definition of DOI in OC is recommended.•DOI ≥ 4 mm is an accurate cut-off value for elective neck dissection (END).•END performed for patients with DOI ≥ 4 mm results in lower regional recur...
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| Veröffentlicht in: | Oral oncology 2020-12, Vol.111, p.104940-104940, Article 104940 |
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| creator | van Lanschot, Cornelia G.F. Klazen, Yoram P. de Ridder, Maria A.J. Mast, Hetty ten Hove, Ivo Hardillo, José A. Monserez, Dominiek A. Sewnaik, Aniel Meeuwis, Cees A. Keereweer, Stijn Aaboubout, Yassine Barroso, Elisa M. van der Toom, Quincy M. Bakker Schut, Tom C. Wolvius, Eppo B. Baatenburg de Jong, Robert J. Puppels, Gerwin J. Koljenović, Senada |
| description | •Depth of invasion (DOI) is associated with lymph node metastasis in oral cancer (OC).•The AJCC (8th edition) definition of DOI in OC is recommended.•DOI ≥ 4 mm is an accurate cut-off value for elective neck dissection (END).•END performed for patients with DOI ≥ 4 mm results in lower regional recurrence.
Depth of invasion (DOI) is the most important predictor for lymph node metastasis (LNM) in early stage (T1-T2) oral cancer. The aim of this study is to validate the cut-off value of 4 mm on which the decision to perform an Elective Neck Dissection (END) is made.
We performed a retrospective study in patients with pathologically proven early stage oral cavity squamous cell carcinoma (OCSCC) without clinical or radiological signs of LNM, who were treated between 2013 and 2018. An END was performed when DOI was ≥ 4 mm and a watchful waiting protocol was applied in patients with DOI |
| doi_str_mv | 10.1016/j.oraloncology.2020.104940 |
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Depth of invasion (DOI) is the most important predictor for lymph node metastasis (LNM) in early stage (T1-T2) oral cancer. The aim of this study is to validate the cut-off value of 4 mm on which the decision to perform an Elective Neck Dissection (END) is made.
We performed a retrospective study in patients with pathologically proven early stage oral cavity squamous cell carcinoma (OCSCC) without clinical or radiological signs of LNM, who were treated between 2013 and 2018. An END was performed when DOI was ≥ 4 mm and a watchful waiting protocol was applied in patients with DOI < 4 mm.
Three hundred patients were included. END was performed in 77% of patients with DOI ≥ 4 mm, of which 36% had occult LNM (pN+). Patients in the watchful waiting group (48%) developed a regional recurrence in 5.2% for DOI < 4 mm and 24.1% for DOI ≥ 4 mm. For DOI ≥ 4 mm, regional recurrence free survival was higher for patients who were treated with END compared to watchful waiting (p = 0.002). A Receiver-Operator-Curve -analysis showed that a DOI cut-off value of 4.0 mm was the optimal threshold for the prediction of occult LNM (95.1% sensitivity, 52.9% specificity).
A DOI of ≥ 4 mm is an accurate cut-off value for performing an END in early stage OCSCC. END results in higher survival rates and lower regional recurrence rates in patients with DOI ≥ 4 mm.</description><identifier>ISSN: 1368-8375</identifier><identifier>EISSN: 1879-0593</identifier><identifier>DOI: 10.1016/j.oraloncology.2020.104940</identifier><identifier>PMID: 32769035</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Depth of invasion ; Elective neck dissection ; Head and neck cancer ; Lymph node metastasis ; Oral cancer ; Oral cavity ; Squamous cell carcinoma</subject><ispartof>Oral oncology, 2020-12, Vol.111, p.104940-104940, Article 104940</ispartof><rights>2020</rights><rights>Copyright © 2020. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-406be1f25a9e0805fc62598112145c3e20a546692600605f232a87f08bb70e0d3</citedby><cites>FETCH-LOGICAL-c498t-406be1f25a9e0805fc62598112145c3e20a546692600605f232a87f08bb70e0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.oraloncology.2020.104940$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32769035$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Lanschot, Cornelia G.F.</creatorcontrib><creatorcontrib>Klazen, Yoram P.</creatorcontrib><creatorcontrib>de Ridder, Maria A.J.</creatorcontrib><creatorcontrib>Mast, Hetty</creatorcontrib><creatorcontrib>ten Hove, Ivo</creatorcontrib><creatorcontrib>Hardillo, José A.</creatorcontrib><creatorcontrib>Monserez, Dominiek A.</creatorcontrib><creatorcontrib>Sewnaik, Aniel</creatorcontrib><creatorcontrib>Meeuwis, Cees A.</creatorcontrib><creatorcontrib>Keereweer, Stijn</creatorcontrib><creatorcontrib>Aaboubout, Yassine</creatorcontrib><creatorcontrib>Barroso, Elisa M.</creatorcontrib><creatorcontrib>van der Toom, Quincy M.</creatorcontrib><creatorcontrib>Bakker Schut, Tom C.</creatorcontrib><creatorcontrib>Wolvius, Eppo B.</creatorcontrib><creatorcontrib>Baatenburg de Jong, Robert J.</creatorcontrib><creatorcontrib>Puppels, Gerwin J.</creatorcontrib><creatorcontrib>Koljenović, Senada</creatorcontrib><title>Depth of invasion in early stage oral cavity squamous cell carcinoma: The optimal cut-off value for elective neck dissection</title><title>Oral oncology</title><addtitle>Oral Oncol</addtitle><description>•Depth of invasion (DOI) is associated with lymph node metastasis in oral cancer (OC).•The AJCC (8th edition) definition of DOI in OC is recommended.•DOI ≥ 4 mm is an accurate cut-off value for elective neck dissection (END).•END performed for patients with DOI ≥ 4 mm results in lower regional recurrence.
Depth of invasion (DOI) is the most important predictor for lymph node metastasis (LNM) in early stage (T1-T2) oral cancer. The aim of this study is to validate the cut-off value of 4 mm on which the decision to perform an Elective Neck Dissection (END) is made.
We performed a retrospective study in patients with pathologically proven early stage oral cavity squamous cell carcinoma (OCSCC) without clinical or radiological signs of LNM, who were treated between 2013 and 2018. An END was performed when DOI was ≥ 4 mm and a watchful waiting protocol was applied in patients with DOI < 4 mm.
Three hundred patients were included. END was performed in 77% of patients with DOI ≥ 4 mm, of which 36% had occult LNM (pN+). Patients in the watchful waiting group (48%) developed a regional recurrence in 5.2% for DOI < 4 mm and 24.1% for DOI ≥ 4 mm. For DOI ≥ 4 mm, regional recurrence free survival was higher for patients who were treated with END compared to watchful waiting (p = 0.002). A Receiver-Operator-Curve -analysis showed that a DOI cut-off value of 4.0 mm was the optimal threshold for the prediction of occult LNM (95.1% sensitivity, 52.9% specificity).
A DOI of ≥ 4 mm is an accurate cut-off value for performing an END in early stage OCSCC. END results in higher survival rates and lower regional recurrence rates in patients with DOI ≥ 4 mm.</description><subject>Depth of invasion</subject><subject>Elective neck dissection</subject><subject>Head and neck cancer</subject><subject>Lymph node metastasis</subject><subject>Oral cancer</subject><subject>Oral cavity</subject><subject>Squamous cell carcinoma</subject><issn>1368-8375</issn><issn>1879-0593</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNkE9v1DAQxS1ERf9-BWRx4pJlbMeO0xtqgSJV4tKeLa8zbr0k8dZOIq3Eh8fRFsSRk8czb-bp_Qj5wGDDgKlPu01Mto-ji318Omw48HVQtzW8IWdMN20FshVvSy2UrrRo5Ck5z3kHAJJJeEdOBW9UC0KekV-3uJ-eafQ0jIvNIY6loGhTf6B5sk9IVy_q7BKm0nmZ7RDnTB32azO5MMbBXtOH5yLcT2FYtfNURe_pYvsZqY-JYo9uCgvSEd1P2oWc138cL8mJt33Gq9f3gjx-_fJwc1fd__j2_ebzfeXqVk9VDWqLzHNpWwQN0jvFZasZ46yWTiAHK2ulWq4AVBlzwa1uPOjttgGETlyQj8e7-xRfZsyTGUJeI9gRSxrDa8E0lw3nRXp9lLoUc07ozT6VVOlgGJiVvtmZf-mblb450i_L71995u2A3d_VP7iL4PYowJJ2CZhMdgFHh11IBYnpYvgfn98hBp2p</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>van Lanschot, Cornelia G.F.</creator><creator>Klazen, Yoram P.</creator><creator>de Ridder, Maria A.J.</creator><creator>Mast, Hetty</creator><creator>ten Hove, Ivo</creator><creator>Hardillo, José A.</creator><creator>Monserez, Dominiek A.</creator><creator>Sewnaik, Aniel</creator><creator>Meeuwis, Cees A.</creator><creator>Keereweer, Stijn</creator><creator>Aaboubout, Yassine</creator><creator>Barroso, Elisa M.</creator><creator>van der Toom, Quincy M.</creator><creator>Bakker Schut, Tom C.</creator><creator>Wolvius, Eppo B.</creator><creator>Baatenburg de Jong, Robert J.</creator><creator>Puppels, Gerwin J.</creator><creator>Koljenović, Senada</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202012</creationdate><title>Depth of invasion in early stage oral cavity squamous cell carcinoma: The optimal cut-off value for elective neck dissection</title><author>van Lanschot, Cornelia G.F. ; 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Depth of invasion (DOI) is the most important predictor for lymph node metastasis (LNM) in early stage (T1-T2) oral cancer. The aim of this study is to validate the cut-off value of 4 mm on which the decision to perform an Elective Neck Dissection (END) is made.
We performed a retrospective study in patients with pathologically proven early stage oral cavity squamous cell carcinoma (OCSCC) without clinical or radiological signs of LNM, who were treated between 2013 and 2018. An END was performed when DOI was ≥ 4 mm and a watchful waiting protocol was applied in patients with DOI < 4 mm.
Three hundred patients were included. END was performed in 77% of patients with DOI ≥ 4 mm, of which 36% had occult LNM (pN+). Patients in the watchful waiting group (48%) developed a regional recurrence in 5.2% for DOI < 4 mm and 24.1% for DOI ≥ 4 mm. For DOI ≥ 4 mm, regional recurrence free survival was higher for patients who were treated with END compared to watchful waiting (p = 0.002). A Receiver-Operator-Curve -analysis showed that a DOI cut-off value of 4.0 mm was the optimal threshold for the prediction of occult LNM (95.1% sensitivity, 52.9% specificity).
A DOI of ≥ 4 mm is an accurate cut-off value for performing an END in early stage OCSCC. END results in higher survival rates and lower regional recurrence rates in patients with DOI ≥ 4 mm.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32769035</pmid><doi>10.1016/j.oraloncology.2020.104940</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Oral oncology, 2020-12, Vol.111, p.104940-104940, Article 104940 |
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| language | eng |
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| source | Elsevier ScienceDirect Journals |
| subjects | Depth of invasion Elective neck dissection Head and neck cancer Lymph node metastasis Oral cancer Oral cavity Squamous cell carcinoma |
| title | Depth of invasion in early stage oral cavity squamous cell carcinoma: The optimal cut-off value for elective neck dissection |
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