TY - JOUR
T1 - Clinical nodal stage is a significant predictor of outcome in patients with oral cavity squamous cell carcinoma and pathologically negative neck metastases
T2 - Results of the international consortium for outcome research
AU - Amit, M.
AU - Yen, T. C.
AU - Liao, C. T.
AU - Binenbaum, Y.
AU - Chaturvedi, P.
AU - Agarwal, J. P.
AU - Kowalski, L. P.
AU - Ebrahimi, A.
AU - Clark, J. R.
AU - Cernea, C. R.
AU - Brandao, S. J.
AU - Kreppel, M.
AU - Zöller, J.
AU - Fliss, D.
AU - Bachar, G.
AU - Shpitzer, T.
AU - Bolzoni, V. A.
AU - Patel, P. R.
AU - Jonnalagadda, S.
AU - Robbins, K. T.
AU - Shah, J. P.
AU - Patel, S. G.
AU - Gil, Ziv
N1 - Funding Information:
ACKNOWLEDGMENT This research was supported by the Israel Science Foundation, the Israel Cancer Association (Grant donated by Ellen and Emanuel Kronitz in memory of Dr. Leon Kronitz; Grant 20090068), the Israeli Ministry of Health (Grant 3-7355), the Weizmann Institute—TASMC Joint Grant, the ICRF Barbara S. Goodman endowed research career development award (Grant 2011-601-BGPC), an Intramural Grant from Rambam Medical Center, and a grant from the U.S.–Israel Binational Science Foundation. Esther Eshkol is thanked for her editorial assistance. We would like to thank Dr. Ester Shabtai and Carmit Rubin, MA, Statistics Services Unit, Tel Aviv, Sourasky Medical Center, Tel Aviv, Israel, for the statistical analysis.
PY - 2013/10
Y1 - 2013/10
N2 - Background: We aimed to study the importance of clinical N classification (cN) in a subgroup of patients with oral cavity squamous cell carcinoma (OSCC) and pathologically negative neck nodes (pN-). Methods: A total of 2,258 patients from 11 cancer centers who underwent neck dissection for OSCC (1990-2011) had pN- disease. The median follow-up was 44 months. 5-year overall survival (OS), disease-specific survival (DSS), disease free survival, local control, locoregional control, and distant metastasis rates were calculated by the Kaplan-Meier method. cN classification and tumor, node, metastasis classification system staging variables were subjected to multivariate analysis. Results: A total of 345 patients were preoperatively classified as cN+ and 1,913 were classified as cN-. The 5-year OS and DSS of cN- patients were 73.6 and 82.2 %, respectively. The 5-year OS and DSS of cN+ patients were 64.9 and 76.9 %, respectively (p < 0.0001 each). A cN+ classification was a significant predictor of worse OS (p = 0.03) and DSS (p = 0.016), regardless of treatment, depth of invasion, or extent of neck dissection. cN classification was associated with recurrence-free survival (p = 0.01) and locoregional (neck and primary tumor) control (p = 0.004), but not with local (p = 0.19) and distant (p = 0.06) recurrence rates. Conclusions: Clinical evidence of neck metastases is an independent predictor of outcome, even in patients with pN- nodes.
AB - Background: We aimed to study the importance of clinical N classification (cN) in a subgroup of patients with oral cavity squamous cell carcinoma (OSCC) and pathologically negative neck nodes (pN-). Methods: A total of 2,258 patients from 11 cancer centers who underwent neck dissection for OSCC (1990-2011) had pN- disease. The median follow-up was 44 months. 5-year overall survival (OS), disease-specific survival (DSS), disease free survival, local control, locoregional control, and distant metastasis rates were calculated by the Kaplan-Meier method. cN classification and tumor, node, metastasis classification system staging variables were subjected to multivariate analysis. Results: A total of 345 patients were preoperatively classified as cN+ and 1,913 were classified as cN-. The 5-year OS and DSS of cN- patients were 73.6 and 82.2 %, respectively. The 5-year OS and DSS of cN+ patients were 64.9 and 76.9 %, respectively (p < 0.0001 each). A cN+ classification was a significant predictor of worse OS (p = 0.03) and DSS (p = 0.016), regardless of treatment, depth of invasion, or extent of neck dissection. cN classification was associated with recurrence-free survival (p = 0.01) and locoregional (neck and primary tumor) control (p = 0.004), but not with local (p = 0.19) and distant (p = 0.06) recurrence rates. Conclusions: Clinical evidence of neck metastases is an independent predictor of outcome, even in patients with pN- nodes.
UR - http://www.scopus.com/inward/record.url?scp=84883814297&partnerID=8YFLogxK
U2 - 10.1245/s10434-013-3044-0
DO - 10.1245/s10434-013-3044-0
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C2 - 23775408
AN - SCOPUS:84883814297
SN - 1068-9265
VL - 20
SP - 3575
EP - 3581
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 11
ER -
