Treatment and Prognosis of Oral Cancer Patients with Confirmed Contralateral Neck Metastasis: A Multicenter Retrospective Analysis

Yuki Sakamoto, Mitsunobu Otsuru, Takumi Hasegawa, Masaya Akashi, Shin-ichi Yamada, Hiroshi Kurita, Masaya Okura, Nobuhiro Yamakawa, Tadaaki Kirita, Souichi Yanamoto, Masahiro Umeda and Yuka Kojima
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Yuki Sakamoto: Department of Dentistry and Oral Surgery, Kansai Medical University Medical Center, Moriguchi 570-8507, Japan
Mitsunobu Otsuru: Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
Takumi Hasegawa: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 652-0032, Japan
Masaya Akashi: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 652-0032, Japan
Shin-ichi Yamada: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-8555, Japan
Hiroshi Kurita: Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
Masaya Okura: Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, Matsusaka 515-8557, Japan
Nobuhiro Yamakawa: Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara 634-8521, Japan
Tadaaki Kirita: Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara 634-8521, Japan
Souichi Yanamoto: Department of Oral Oncology, Hiroshima University, Hiroshima 739-8511, Japan
Masahiro Umeda: Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan
Yuka Kojima: Department of Dentistry and Oral Surgery, Kansai Medical University, Hirakata 573-1191, Japan

IJERPH, 2022, vol. 19, issue 15, 1-12

Abstract: The prognosis of oral cancer that has metastasized to the contralateral cervical lymph nodes is poor, although the appropriate treatment method has not been established because of its rarity. A multicenter retrospective study on the treatment and prognosis of pN2c oral cancer patients was conducted. We investigated the treatment and prognosis of 62 pN2c patients out of 388 pN+ patients with oral squamous cell carcinomas. Statistical analysis was performed on the various factors with overall survival (OS) and disease specific survival (DSS). In multivariate cox regression analysis, advanced T stage was significantly correlated with poor OS ( p = 0.011) and DSS ( p = 0.023) of patients with pN2c neck. In pN2c patients, OS, DSS, and neck control was not different between those undergoing ipsilateral neck dissection initially and those undergoing bilateral neck dissection. Thus, contralateral elective neck dissection is not recommended. The most important risk factor for prognosis in pN2c oral cancer patients is advanced T stage. No evidence was found to recommend contralateral elective neck dissection in clinically N1/2b patients. Therefore, the indication for contralateral elective neck dissection in N1/2b patients should be carefully determined in consideration of individual conditions.

Keywords: mouth neoplasms; lymphatic metastasis; prognosis; neck dissection; risk factor (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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