Adequacy of Disease Control by Supraomohyoid Neck Dissection in cT1/T2 Tongue Cancer

Andrea Iandelli; Filippo Marchi; An-Chieh Chen; Chi-Kuan Young; Chun-Ta Liao; Chung-Kan Tsao; Chung-Jan Kang; Hung-Ming Wang; Tung-Chieh Joseph Chang; Shiang-Fu Huang

doi:10.3390/jpm12091535

Adequacy of Disease Control by Supraomohyoid Neck Dissection in cT1/T2 Tongue Cancer

J Pers Med. 2022 Sep 19;12(9):1535. doi: 10.3390/jpm12091535.

Authors

Andrea Iandelli^{1

2

3}, Filippo Marchi^{2

3

4}, An-Chieh Chen¹, Chi-Kuan Young^{5

6}, Chun-Ta Liao^{1

6}, Chung-Kan Tsao^{4

6}, Chung-Jan Kang^{1

6}, Hung-Ming Wang^{6

7}, Tung-Chieh Joseph Chang^{6

8}, Shiang-Fu Huang^{1

9}

Affiliations

¹ Department of Otorhinolaryngology and Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Branch, Yaoyuan 33302, Taiwan.
² Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
³ Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, 16132 Genova, Italy.
⁴ Department of Plastic Surgery, Chang Gung Memorial, Linkou Branch, Taoyuan 333, Taiwan.
⁵ Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial, Keelung Branch, Keelung 20401, Taiwan.
⁶ School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
⁷ Department of Medical Oncology, Internal Medicine, Chang Gung Memorial, Linkou Branch, Taoyuan 333, Taiwan.
⁸ Department of Radiation Oncology, Chang Gung Memorial, Linkou Branch, Taoyuan 333, Taiwan.
⁹ Graduate Institute of Clinical Medical Sciences, Chang Gun Medical College, Chang Gung University, Taoyuan 33302, Taiwan.

Abstract

Background: Patients affected by oral tongue squamous cell carcinoma (OTSCC) underwent a supraomohyoid neck dissection (SOHND) or modified radical neck dissection (mRND) according to the clinical nodal status (cN0 vs. cN+). We investigate whether the type of neck dissection affects survival with the presence of extranodal extension (ENE) and multiple nodal metastases (MNM).

Methods: We conducted a retrospective study enrolling surgically treated patients affected by cT1/T2 OTSCC and MNM or ENE. The outcomes assessed were: overall survival (OS), disease-free survival (DFS), and neck-control- and metastases-free survival (NC-MFS). Survival curves were plotted by the Kaplan-Meier method and the log-rank test. Furthermore, we conducted a multivariable analysis with the Cox regression model.

Results: We included a total of 565 patients (36% cT1, 64% cT2). Of these, 501 patients underwent a SOHND, and 64 underwent an mRND. A total of 184 patients presented rpN+, with 28.7% of these in the SOHND group and 62.5% of these in the mRND group. We identified no significant differences in OS, DFS, and NC-MFS in the whole pN+ cohort, in the MNM, and the ENE subgroups. In the multivariable analysis, the type of ND did not affect OS and DFS.

Conclusions: Treating cT1-2 N0/+ tongue cancer with SOHND is oncologically safe. ENE and MNM patients do not benefit from an mRND.

Keywords: head and neck cancer; neck dissection; oral cancer; skip metastases; supraomohyoid neck dissection; tongue cancers.

Abstract

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