Akheel Mohammad, Wadhwania Ashmi, Venkataramu Vinay, Vijay Tanvi, Qazi Mukhallat, Suneja Ridhima
College of Dentistry, City University Ajman, Ajman, UAE.
Adjunct Faculty, Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3750-3756. doi: 10.1007/s12070-023-04057-w. Epub 2023 Jul 20.
The surgical management of the clinically node negative neck in T1-T2 early oral tongue squamous cell carcinoma (OTSCC) has been the topic of debate since few decades. As the occult cervical lymph node metastasis is considered to be the primary prognostic factor in early OTSCC, this meta-analysis has been carried out to find the risk of regional nodal recurrence on patients kept under observation than those who have underwent Elective neck dissection (END). The articles were electronically retrieved from Ovid Medline, PubMed, Cochrane and Scholar for comparison of Observation versus END in early OTSCC. The search strategy identified 35 relevant review articles from April 1979 to April 2020 from different search engines. A total of 11,973 patients from 30 retrospective analyses, 4 prospective and 1 randomized control trials were included in this meta-analysis. Overall test revealed (OR: 13.02 95% CI 1.360-17.154) with t test 2.382 and p value 0.023 which is statistically significant and showed that END significantly reduced the risk of regional nodal recurrence. This meta-analysis finds that there is statistically significant relationship when END was performed which reduced the risk of regional nodal recurrence as seen in patients kept on Observation thereby affecting the Overall survival (OS) rate.
几十年来，T1-T2期早期口腔舌鳞状细胞癌（OTSCC）临床颈部淋巴结阴性患者的手术治疗一直是一个有争议的话题。由于隐匿性颈淋巴结转移被认为是早期OTSCC的主要预后因素，因此进行了这项荟萃分析，以比较观察等待患者与接受择区颈清扫术（END）患者的区域淋巴结复发风险。通过电子检索Ovid Medline、PubMed、Cochrane和学术搜索数据库，以比较早期OTSCC中观察等待与END的情况。搜索策略从不同搜索引擎中识别出1979年4月至2020年4月的35篇相关综述文章。本荟萃分析共纳入了来自30项回顾性分析、4项前瞻性研究和1项随机对照试验的11973例患者。总体检验显示（比值比：13.02，95%置信区间1.360-17.154），t检验值为2.382，p值为0.023，具有统计学意义，表明END显著降低了区域淋巴结复发风险。该荟萃分析发现，进行END时存在统计学显著关系，可降低区域淋巴结复发风险，这在观察等待的患者中也有体现，从而影响总生存率（OS）。
