Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, 6th Nile Valley Street, Hadayek Alkoba, Cairo, 11331, Egypt.
Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1741-1752. doi: 10.1007/s00405-020-05866-3. Epub 2020 Feb 25.
Oral squamous cell carcinoma (SCC) is characterized by a high risk of cervical lymph node metastasis with a high incidence of occult metastasis. A strong debate is still present regarding the best treatment for early oral cavity cancer with N0 neck.
The aim of the present study was to compare between the results of elective neck dissection (END) and watchful waiting (observation or therapeutic neck dissection) in patients with early-stage (T1/T2) oral squamous cell carcinoma with N0 neck.
Medline database (https://www.pubmed.com), Google Scholar and Scopus.
A systematic review and meta-analysis for the evaluation of regional recurrence rate and 5-year survival rate after elective neck dissection (END) or watchful waiting in early oral cancers were conducted. This study included published English medical articles (which met our predetermined inclusion criteria) in the last 30 years, concerning early oral SCC with N0 neck. 24 articles were included (4 randomized studies and 20 observational "retrospective" studies) with a total number of 2190 of patients who underwent END and 1619 who underwent watchful waiting. Regarding the 5-year survival rate, (10) studies were included with a total number of 1211 patients who underwent END and 948 who underwent watchful waiting.
Regarding the regional recurrence rate, (END) was associated with significantly lower risk of recurrence when compared with observation. Regarding the 5-year survival rate, END was associated with a better survival rate than the observational group.
Elective neck dissection is better than watchful waiting in early (T1/T2) stage oral cavity squamous cell carcinoma with N0 neck, regarding regional recurrence and 5-year survival rate.
口腔鳞状细胞癌（SCC）的特点是颈部淋巴结转移风险高，隐匿性转移发生率高。对于 N0 颈的早期口腔癌，目前仍存在强烈的治疗方法争议。
本研究旨在比较选择性颈部清扫术（END）与观察等待（观察或治疗性颈部清扫术）在 N0 颈早期口腔鳞状细胞癌（T1/T2）患者中的结果。
Medline 数据库（https://www.pubmed.com）、Google Scholar 和 Scopus。
对评价选择性颈部清扫术（END）或观察等待在早期口腔癌中的区域复发率和 5 年生存率的系统评价和荟萃分析进行了检索。本研究纳入了过去 30 年发表的符合我们预定纳入标准的关于 N0 颈早期口腔 SCC 的英文医学文章。共纳入 24 篇文章（4 项随机研究和 20 项观察性“回顾性”研究），其中 END 组 2190 例，观察组 1619 例。关于 5 年生存率，共纳入 10 项研究，END 组 1211 例，观察组 948 例。
在区域复发率方面，与观察相比，END 与复发风险显著降低相关。在 5 年生存率方面，END 组的生存率优于观察组。
对于 N0 颈的早期（T1/T2）口腔鳞状细胞癌，选择性颈部清扫术在区域复发和 5 年生存率方面优于观察等待。
