Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases

Kevin Y. Zhan, Patrick F. Morgan, David M. Neskey, Joanne J. Kim, Andrew T. Huang, Elizabeth Garrett-Mayer, Terry A. Day

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: Nodal disease predicts survival in oral cavity squamous cell carcinoma (SCC). Currently, no large studies on predictors of occult nodal disease in cT1N0 oral cavity SCC exist. Methods: The National Cancer Database (NCDB) review for cT1N0 oral cavity SCC with surgical resection and elective neck dissection (END). Results: The number of patients found with occult nodal disease was 2623 (15.1%). In multivariable regression, female sex and tumor differentiation predict occult nodal disease. Occult nodal disease incidence was 5.9% in well-differentiated tumors, 17.4% in moderately differentiated tumors, and 28.5% in poorly differentiated tumor (P <.001). Women with oral tongue tumors had higher occult nodal disease (19.1%) than men (12%; P =.001). Adjusted odds ratios (aORs) for occult nodal disease in women were: aOR 1.26; 95% confidence interval (CI) 1.01-1.59; P =.045; moderately differentiated aOR 3.52; 95% CI 2.47-5.01; P <.001; and poorly differentiated aOR 6.25; 95% CI 4.17-9.38; P <.001. Conclusion: Sex and tumor differentiation significantly predict occult nodal disease. END is recommended for all moderately and poorly differentiated cT1N0 oral cavity SCC, regardless of the depth of invasion. One can consider not performing END in well-differentiated tumors.

Original languageEnglish (US)
Pages (from-to)1967-1976
Number of pages10
JournalHead and Neck
Volume40
Issue number9
DOIs
StatePublished - Sep 2018
Externally publishedYes

Keywords

  • depth of invasion
  • neck dissection
  • occult nodal disease
  • oral cancer
  • squamous cell carcinoma
  • tumor differentiation

ASJC Scopus subject areas

  • Otorhinolaryngology

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