Department of Head and Neck Surgical Oncology, TMH, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, Mumbai, India; Consultant Head & Neck Surgeon, Fortis Hospital, Mulund, Mumbai, India.
Department of Head and Neck Surgical Oncology, TMH, Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute, Mumbai, India.
Eur J Surg Oncol. 2021 Jun;47(6):1384-1388. doi: 10.1016/j.ejso.2020.11.143. Epub 2020 Nov 30.
Evidence for performing contralateral neck dissection (CND) of recurrent oral cavity squamous cell cancers (OCSCC) is lacking.
This is a retrospective study of 78 consecutive OCSCC having ipsilateral recurrence recorded over five years. We screened 1658 OCSCC patients and selected those patients who underwent CND as part of treatment for ipsilateral recurrence.
The median disease-free interval was 32 months. Incidence of contralateral nodal metastasis (CNM) in recurrent OCSCC was 23.1% and of which 14% were occult. The factor significantly influencing CNM was the depth of invasion (DOI) > 10 mm (p < 0.01). In our study, imaging had suboptimal PPV (33%) while it had high NPV (88%) in diagnosing nodal metastasis in recurrent OCSCC.
DOI is the most important factor predicting CNM in case of ipsilateral primary recurrence. PET-CECT has a high NPV and contralateral neck should be addressed in case of tumours with higher DOI.
对于复发性口腔鳞状细胞癌（OCSCC）行对侧颈部清扫术（CND）的证据不足。
这是一项对五年内记录到同侧复发的 78 例连续 OCSCC 患者进行的回顾性研究。我们筛查了 1658 例 OCSCC 患者，并选择了那些作为同侧复发治疗一部分而行 CND 的患者。
中位无病间隔时间为 32 个月。复发性 OCSCC 对侧淋巴结转移（CNM）的发生率为 23.1%，其中 14%为隐匿性。影响 CNM 的重要因素是浸润深度（DOI）>10mm（p<0.01）。在我们的研究中，影像学检查对复发性 OCSCC 中淋巴结转移的预测具有较低的阳性预测值（33%），但具有较高的阴性预测值（88%）。
对于同侧原发性复发的病例，DOI 是预测 CNM 的最重要因素。如果肿瘤的 DOI 较高，应行 PET-CECT 检查，以确定是否行对侧颈部处理。
