Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia; Central Clinical School, University of Sydney, Sydney, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
Oral Oncol. 2020 Jun;105:104661. doi: 10.1016/j.oraloncology.2020.104661. Epub 2020 Mar 31.
Oral squamous cell carcinoma (OSCC) is the seventh most common cancer globally, and has been identified as a growing health concern. This study aims to evaluate the current literature comparing elective neck dissection to observation in the treatment of early-stage tongue SCC, focusing on nodal recurrence, overall survival, disease specific survival statistics from randomised controlled trials comparing the two interventions.
Systematic review and meta-analysis was conducted according to PRISMA guidelines. The odds ratio (OR) was used as a summary statistic.
From 8 studies, there was a total of 372 cases of recurrence, 98 (15.1%) in END group and 274 (41.5%) in the Observation group. There was a significantly lower rate of recurrence in the END group compared to observation (OR 0.25, 95% CI 0.16-0.39, I = 54%, P < 0.00001). END was associated with higher overall survival rates when compared with observation (OR 1.95, 95% CI 1.40-2.73, I = 14%, P < 0.0001). END was also associated with higher disease-specific survival compared with observation (OR 1.88, 95% CI 1.21-2.93), I = 47%, P = 0.005), with no significant heterogeneity noted.
END was associated with significantly lower recurrence rates and higher overall and disease-specific survival compared to a conservative observation approach in early-stage oral SCC with clinically N0 neck.
口腔鳞状细胞癌（OSCC）是全球第七大常见癌症，已被确定为一个日益严重的健康问题。本研究旨在评估目前比较选择性颈部清扫术与观察治疗早期舌 SCC 的文献，重点关注淋巴结复发、总生存率、疾病特异性生存率，比较两种干预措施的随机对照试验的统计数据。
根据 PRISMA 指南进行系统评价和荟萃分析。使用优势比（OR）作为汇总统计量。
从 8 项研究中，共有 372 例复发病例，END 组 98 例（15.1%），观察组 274 例（41.5%）。与观察组相比，END 组的复发率显著降低（OR 0.25，95%CI 0.16-0.39，I=54%，P<0.00001）。与观察组相比，END 与更高的总生存率相关（OR 1.95，95%CI 1.40-2.73，I=14%，P<0.0001）。与观察组相比，END 还与更高的疾病特异性生存率相关（OR 1.88，95%CI 1.21-2.93），I=47%，P=0.005），且无显著异质性。
与保守观察方法相比，在临床 N0 颈部的早期口腔 SCC 中，END 与显著降低的复发率以及更高的总生存率和疾病特异性生存率相关。
