Contralateral neck failure in oral tongue cancer: Outcomes from two centers using predefined treatment criteria

Cristian Udovicich; James Daniell; David Wiesenfeld; Mathias Bressel; David Rowe; Domenic Vital; Karda Cavanagh; Ernest Lekgabe; Tim Wong; Matthew J R Magarey; Tim A Iseli; Tsien Fua; Danny Rischin; Lachlan McDowell

doi:10.1002/hed.26671

Contralateral neck failure in oral tongue cancer: Outcomes from two centers using predefined treatment criteria

Head Neck. 2021 Jul;43(7):2024-2031. doi: 10.1002/hed.26671. Epub 2021 Mar 17.

Authors

Cristian Udovicich^{1

2}, James Daniell³, David Wiesenfeld³, Mathias Bressel⁴, David Rowe³, Domenic Vital³, Karda Cavanagh⁵, Ernest Lekgabe⁶, Tim Wong³, Matthew J R Magarey^{7

8}, Tim A Iseli³, Tsien Fua^{1

2}, Danny Rischin^{2

9}, Lachlan McDowell^{1

2}

Affiliations

¹ Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
² Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia.
³ Head and Neck Tumour Stream, Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁵ Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁶ Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁷ Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁸ Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia.
⁹ Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

PMID: 33729633
DOI: 10.1002/hed.26671

Abstract

Background: The objective was to determine the incidence of, and factors associated with contralateral neck failure (CNF) in oral tongue squamous cell carcinoma (OTSCC).

Methods: Consecutive patients with OTSCC between 2007 and 2016 were included. The predefined policy of the contralateral neck included neck dissection (ND) where the primary tumor extended/crossed midline or the contralateral neck was involved; and elective nodal irradiation (ENI) where the primary tumor was ≤1 cm from midline/2 cm from tip.

Results: This study included 258 patients. ND was ipsilateral 169 (66%) and bilateral 33 (13%). Fifty-five patients (21%) received ENI to the undissected contralateral neck. CNF occurred in 19 patients (7%) and was similar by treatment received. Utilizing this approach, we observed higher rates of CNF with increasing N classification, perineural invasion, extracapsular extension, and depth of invasion ≥6 mm.

Conclusions: Using our institutional policy of treatment to the contralateral neck, a low rate of CNF (≤10%) was observed.

Keywords: contralateral lymph node metastasis; head and neck cancer; oral tongue squamous cell carcinoma; radiation therapy; surgery.

MeSH terms

Carcinoma, Squamous Cell* / pathology
Carcinoma, Squamous Cell* / surgery
Humans
Mouth Neoplasms*
Neck Dissection
Neoplasm Staging
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck
Tongue Neoplasms* / pathology
Tongue Neoplasms* / surgery