Elective Neck Dissection Versus Observation in cT1-T2 Oral Tongue Squamous Cell Carcinoma: A Meta-Analysis of 11,973 Patients

Mohammad Akheel; Rinku K George; Sukirti Tiwari; Amit Jain; Qutubuddin Chahwala; Ashmi Wadhwania

doi:10.1007/s12070-020-02118-y

Elective Neck Dissection Versus Observation in cT1-T2 Oral Tongue Squamous Cell Carcinoma: A Meta-Analysis of 11,973 Patients

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2256-2264. doi: 10.1007/s12070-020-02118-y. Epub 2020 Sep 2.

Authors

Mohammad Akheel¹, Rinku K George¹, Sukirti Tiwari², Amit Jain³, Qutubuddin Chahwala⁴, Ashmi Wadhwania⁵

Affiliations

¹ Oral & Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu India.
² Consultant Oral and Maxillofacial Surgeon, Delhi, India.
³ Consultant radiation oncologist, SRJ-CBCC Cancer Centre, Indore, India.
⁴ Consultant histopathologist, CHL Hospitals, Indore, India.
⁵ Consultant Oral and Maxillofacial Surgeon, Indore, India.

Abstract

The surgical management of the clinical negative neck node in early oral tongue squamous cell carcinoma (OTSCC) has been the topic of debate since few decades. As the occult cervical lymph node metastasis is considered to be the prime prognostic factor in early OTSCC, this meta-analysis has been carried out to find the risk of regional nodal recurrence, disease specific survival and overall survival rates in outcome of Elective neck dissection (END) versus patients under observation. The articles were electronically retrieved from Ovid Medline, PubMed, Cochrane and Scholar for comparison of END versus Observation in early OTSCC. The search strategy identified 37 relevant review articles from April 1979 to April 2020 from different search engines. A total of 11,973 patients from 32 retrospective analysis, 4 prospective and 1 randomised control trial were included in this meta-analysis. Statistical analysis revealed Overall test (OR: 5.31 95% CI: - 2.132-14.698) with t-test 1.919 and p value 0.113 which is not statistically significant but the readings says that there is always better Disease specific survival with END patients rather than patients kept on observation. Overall test revealed (OR: 13.02 95% CI: 1.360-17.154) with t test 2.382 and p value 0.023 which is statistically significant and showed that End significantly reduced the risk of regional nodal recurrence. Overall test revealed (OR: 7.93 95% CI: - 15.461-4.238) with t test - 1.347 and p value 0.220 which is statistically insignificant and but showed that to some extent Overall survival improves in patient with END than the patients kept on observation. This meta-analysis find that there is statistically significant relationship when Elective neck dissection was performed which reduced the risk of regional nodal recurrence. This analysis didn't statistically find any significance in Disease specific survival and Overall survival with Elective neck dissection patients rather than patients kept on observation but however showed good prognosis when elective neck dissection was performed.

Keywords: End; Observation; Oral tongue squamous cell carcinoma; Prognosis.