TY - JOUR
T1 - Outcome after elective neck dissection and observation for the treatment of the clinically node-negative neck (cN0) in squamous cell carcinoma of the oropharynx
AU - Böscke, R.
AU - Cakir, B. D.
AU - Hoffmann, A. S.
AU - Wiegand, S.
AU - Quetz, J.
AU - Meyer, J. E.
PY - 2014/3/1
Y1 - 2014/3/1
N2 - Optimal elective neck treatment in node-negative (cN0) oropharyngeal squamous cell carcinoma (OPSCC) patients is still controversially discussed. Retrospective chart review of 49 cT1-3 cN0 cM0 OPSCC patients, who had undergone surgical resection of the primary and either elective neck dissection (END) (n = 32) or observation (OBS) (n = 17) of the neck was performed. For systematic review of literature, Pubmed and EMBASE were searched for clinical studies including data on both END and OBS of the neck in cN0 OPSCC patients. Estimated 5-year overall survival (OS) rate was 82 % for END and 76 % for OBS [hazard ratio (HR) = 1.01]. Estimated 5-year disease-free survival (DFS) rate was 78 % for END and 67 % for OBS (HR = 1.79); 5-year DSS rate was 97 % (END) and 81 % (OBS) (HR = 2.22). None of the primary outcome variables (OS, DFS, DSS) revealed statistically significant effects for the treatment assignments. Hazard ratios implied an advantage for END. Systematic review of literature yielded only retrospective chart reviews and no data meeting our selection criteria for further data analysis. Due to lack of high-level evidence, the decision for END in cN0 OPSCC remains a diagnostic and therapeutic challenge. The demonstrated clinical equipoise would provide a solid basis for a multicentric, randomized trial.
AB - Optimal elective neck treatment in node-negative (cN0) oropharyngeal squamous cell carcinoma (OPSCC) patients is still controversially discussed. Retrospective chart review of 49 cT1-3 cN0 cM0 OPSCC patients, who had undergone surgical resection of the primary and either elective neck dissection (END) (n = 32) or observation (OBS) (n = 17) of the neck was performed. For systematic review of literature, Pubmed and EMBASE were searched for clinical studies including data on both END and OBS of the neck in cN0 OPSCC patients. Estimated 5-year overall survival (OS) rate was 82 % for END and 76 % for OBS [hazard ratio (HR) = 1.01]. Estimated 5-year disease-free survival (DFS) rate was 78 % for END and 67 % for OBS (HR = 1.79); 5-year DSS rate was 97 % (END) and 81 % (OBS) (HR = 2.22). None of the primary outcome variables (OS, DFS, DSS) revealed statistically significant effects for the treatment assignments. Hazard ratios implied an advantage for END. Systematic review of literature yielded only retrospective chart reviews and no data meeting our selection criteria for further data analysis. Due to lack of high-level evidence, the decision for END in cN0 OPSCC remains a diagnostic and therapeutic challenge. The demonstrated clinical equipoise would provide a solid basis for a multicentric, randomized trial.
UR - http://www.scopus.com/inward/record.url?scp=84896724688&partnerID=8YFLogxK
U2 - 10.1007/s00405-013-2545-6
DO - 10.1007/s00405-013-2545-6
M3 - Journal articles
C2 - 23661061
AN - SCOPUS:84896724688
SN - 0937-4477
VL - 271
SP - 567
EP - 574
JO - European Archives of Oto-Rhino-Laryngology
JF - European Archives of Oto-Rhino-Laryngology
IS - 3
ER -