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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Management of Clinically Negative Neck in Early-Stage (T1-2N0) Oral Squamous-Cell Carcinoma (OSCC): Ten Years of a Single Institution’s Experience

by
Danilo Di Giorgio
1,
Marco Della Monaca
1,
Riccardo Nocini
2,*,
Andrea Battisti
1,
Federica Orsina Ferri
1,
Paolo Priore
1,
Valentina Terenzi
3 and
Valentino Valentini
1
1
Department of Odontostomatological and Maxillofacial Sciences, La Sapienza University of Rome, 00185 Rome, Italy
2
Unit of Otolaryngology, Head and Neck Department, University of Verona, 37134 Verona, Italy
3
Department of Surgical Sciences, Tor Vergata University, 00133 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(23), 7067; https://doi.org/10.3390/jcm13237067
Submission received: 13 September 2024 / Revised: 10 November 2024 / Accepted: 18 November 2024 / Published: 22 November 2024
(This article belongs to the Section Otolaryngology)
Versions Notes

Abstract

Background/Objectives: Oral cavity squamous-cell carcinoma is among the most frequent head and neck neoplasms. Early-stage T1/T2N0 accounts for 40/45% of new diagnoses. Of these, about 30% of cases hide occult metastases in the neck. The management of clinically N0 neck is of paramount importance and is still being debated. Methods: The medical records of patients with a clinical diagnosis of early-stage T1-T2N0 carcinoma of the oral cavity between 2011 and 2021 were retrospectively analysed. The inclusion criteria were complete medical and radiological records, pT1-2 pathology staging, and a minimum follow-up of 24 months. Biographical, management, and survival data were analysed using IBM SPSS Statistics [28.0.1.1]; IBM Corp., Armonk, NY, USA). Results: A total of 121 patients met the inclusion criteria. The tongue was the most affected site, with 52 cases. All patients underwent resection of the primary tumour; for neck management, 47 (38.8%) underwent elective neck dissection, 36 underwent follow-up, and 11 underwent sentinel lymph node biopsy. A total of 59 cases were staged as T1 and 62 as T2; in 97 (80.2%) cases, the neck was confirmed as N0; in 10 (8.3%), N1; in 1 case, N2a; in 8, N2b; in 2, N2c; and in 3, N3b. The mean DOI was 4.8 mm. In a Cox regression, a statistically significant association was shown between overall survival and pN staging (p < 0.05). Kaplan–Meier analysis showed a statistically significant difference between different regimens of management of the neck in terms of overall survival, disease-free survival, and disease-specific survival in favour of elective neck dissection and sentinel lymph node biopsy compared to watchful policy (p < 0.05). Conclusions: Elective neck dissection and sentinel lymph node biopsy proved to be safe and oncologically effective in the treatment of clinically N0 early-stage oral carcinoma.
Keywords: OSCC; early stage; oral cavity cancer; T1T2N0; neck management OSCC; early stage; oral cavity cancer; T1T2N0; neck management

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MDPI and ACS Style

Di Giorgio, D.; Della Monaca, M.; Nocini, R.; Battisti, A.; Ferri, F.O.; Priore, P.; Terenzi, V.; Valentini, V. Management of Clinically Negative Neck in Early-Stage (T1-2N0) Oral Squamous-Cell Carcinoma (OSCC): Ten Years of a Single Institution’s Experience. J. Clin. Med. 2024, 13, 7067. https://doi.org/10.3390/jcm13237067

AMA Style

Di Giorgio D, Della Monaca M, Nocini R, Battisti A, Ferri FO, Priore P, Terenzi V, Valentini V. Management of Clinically Negative Neck in Early-Stage (T1-2N0) Oral Squamous-Cell Carcinoma (OSCC): Ten Years of a Single Institution’s Experience. Journal of Clinical Medicine. 2024; 13(23):7067. https://doi.org/10.3390/jcm13237067

Chicago/Turabian Style

Di Giorgio, Danilo, Marco Della Monaca, Riccardo Nocini, Andrea Battisti, Federica Orsina Ferri, Paolo Priore, Valentina Terenzi, and Valentino Valentini. 2024. "Management of Clinically Negative Neck in Early-Stage (T1-2N0) Oral Squamous-Cell Carcinoma (OSCC): Ten Years of a Single Institution’s Experience" Journal of Clinical Medicine 13, no. 23: 7067. https://doi.org/10.3390/jcm13237067

APA Style

Di Giorgio, D., Della Monaca, M., Nocini, R., Battisti, A., Ferri, F. O., Priore, P., Terenzi, V., & Valentini, V. (2024). Management of Clinically Negative Neck in Early-Stage (T1-2N0) Oral Squamous-Cell Carcinoma (OSCC): Ten Years of a Single Institution’s Experience. Journal of Clinical Medicine, 13(23), 7067. https://doi.org/10.3390/jcm13237067

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