The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma
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Prophylactic neck dissection (PND) for patients with clinically N0 (cN0) tongue carcinoma remains controversial. We assessed the efficacy of PND for patients with cN0 tongue squamous cell carcinoma (SCC) and investigated the prognostic role of tumor thickness as assessed by diagnostic imaging in predicting the risk of nodal micrometastasis or late nodal recurrence. Eighty-eight patients with cN0 tongue carcinomas underwent surgical treatment. Tumor thickness was measured from magnetic resonance (MR) images or computed tomography (CT) scans. The overall survival rates of patients with or without PND were 94 and 81 %, respectively (p = 0.2857). MR images or CT scans were available for 68 patients. A tumor thickness ≥10 mm or ≥5 mm did not increase the probability of nodal metastasis, with late nodal metastasis observed in 15 % of patients with graphically undetected small tumors. PND appears to have the potential to improve overall survival for patients with cN0 tongue SCC. Careful follow-up management or PND is considered to be needed regardless of tumor thickness in the pre-treatment evaluation.
KeywordsTongue cancer Nodal metastasis Neck dissection Tumor thickness
This study was supported in part by Health and Labour Sciences Research Grants for Clinical Cancer Research (H22-017 and H26-141) from the Ministry of Health, and Labour and Welfare of Japan, the National Cancer Center Research and Development Fund (23-A-21 and 26-A-4) of Japan.
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Conflict of interest
No conflict exists: Author Nayuta Tsushima, declares that he has no conflict of interest. Author Tomohiro Sakashita, declares that he has no conflict of interest. Author Akihiro Homma, declares that he has no conflict of interest. Author Hiromitsu Hatakeyama, declares that he has no conflict of interest. Author Satoshi Kano, Author Takatsugu Mizumachi,declares that he has no conflict of interest. Author Tomohiko Kakizaki, declares that he has no conflict of interest. Author Takayoshi Suzuki declares that he has no conflict of interest. Author Satoshi Fukuda, declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.