PDF(Pubmed)
Abstract：
The neck control strategies of early-stage oral squamous cell carcinoma (OSCC) patients with clinical node-negative neck remain uncertain. These patients could be benefit from elective neck dissection (END) alongside primary tumor excision; but current evidence on END versus observation for OSCC of stage I only is not yet analyzed collectively in detail. Herein, this short communication aimed to evaluate the neck control strategies of stage I OSCC, mainly END versus observation. A total of 740 patients with stage I OSCC, comprising 434 underwent END and 306 received observation, were identified from literature. The results showed that stage I OSCC patients would not be benefit from END based on the analysis of neck nodal recurrence and overall survival. An ideal strategy would likely be to avoid neck dissection for stage I OSCC patients with N0 neck. Immune checkpoint therapy is such a potential strategy, which aims at eliciting potent antitumor immune responses within lymph nodes hold promise for treating patients with early-stage OSCC and may prove more efficacious than lymphadenectomy in a variety of scenarios. Consequently, neck dissection for stage I OSCC could be approached with caution, particularly in patients receiving immune checkpoint therapy.
摘要：
临床淋巴结阴性的早期口腔鳞状细胞癌（OSCC）患者的颈部控制策略仍不确定。这些患者可以从选择性颈淋巴结清扫术（END）和原发性肿瘤切除术中受益；但是目前关于END的证据与仅I期OSCC的观察结果尚未进行详细分析。在这里，这篇简短的通讯旨在评估I期OSCC的颈部控制策略，主要是结束与观察。共有740名I期OSCC患者，其中434人接受了END，306人接受了观察，是从文学中鉴定出来的。结果显示，根据颈部淋巴结复发和总生存期的分析，I期OSCC患者不会从END中受益。理想的策略可能是避免对N0颈部的I期OSCC患者进行颈部解剖。免疫检查点疗法是一种潜在的策略，旨在在淋巴结内引发有效的抗肿瘤免疫反应，有望治疗早期OSCC患者，并且在各种情况下可能比淋巴结清扫术更有效。因此,I期OSCC的颈清扫术可以谨慎处理，特别是在接受免疫检查点治疗的患者中。
