Metastases to level IIb in squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis

Jane Lea; Gideon Bachar; Anna M. Sawka; Deepak C. Lakra; Ralph W. Gilbert; Jonathan C. Irish; Dale H. Brown; Patrick J. Gullane; David P. Goldstein

doi:10.1002/hed.21163

Metastases to level IIb in squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis

Jane Lea, Gideon Bachar, Anna M. Sawka, Deepak C. Lakra, Ralph W. Gilbert, Jonathan C. Irish, Dale H. Brown, Patrick J. Gullane, David P. Goldstein

Research output: Contribution to journal › Article › peer-review

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Abstract

Background. In this study, a meta-analysis of level IIb metastases in squamous cell carcinoma (SCC) of the oral cavity was conducted. Methods. Two independent reviewers screened abstracts and full text papers deemed potentially relevant. Data were pooled using a random intercept model. Results. In this analysis, 729 abstracts and 177 full text papers were screened (Kappa statistic 0.8 and 1.0, respectively). A total of 332 patients in 9 papers were included in the analysis. Twenty patients had level IIb metastases (mean, 6%; range, 0% to 10.4%). The pooled percentage of level IIb metastases was 6.0% (95% CI: 3.5-8.6). Only 3 patients with level IIb metastases had isolated nodal disease. Eighty-five percent of those with level IIb metastases had additional nodal disease (95% CI: 64.0-94.8), with IIa being a common denominator among all. Conclusion. Level IIb nodal metastases are relatively uncommon in previously untreated SCC of the oral cavity (6%). Furthermore, isolated level IIb nodal disease is uncommon. However, given the quality of evidence to date, it is recommended that dissection of level IIb remain the standard of care in oral cavity squamous cell cancer.

Original language	English
Pages (from-to)	184-190
Number of pages	7
Journal	Head and Neck
Volume	32
Issue number	2
DOIs	https://doi.org/10.1002/hed.21163
State	Published - Feb 2010
Externally published	Yes

Keywords

Level IIb
Meta-analysis
Neck dissection
Oral cavity
Squamous cell carcinoma
Submuscular recess
Systematic review

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Metastases to level IIb in squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis",

abstract = "Background. In this study, a meta-analysis of level IIb metastases in squamous cell carcinoma (SCC) of the oral cavity was conducted. Methods. Two independent reviewers screened abstracts and full text papers deemed potentially relevant. Data were pooled using a random intercept model. Results. In this analysis, 729 abstracts and 177 full text papers were screened (Kappa statistic 0.8 and 1.0, respectively). A total of 332 patients in 9 papers were included in the analysis. Twenty patients had level IIb metastases (mean, 6%; range, 0% to 10.4%). The pooled percentage of level IIb metastases was 6.0% (95% CI: 3.5-8.6). Only 3 patients with level IIb metastases had isolated nodal disease. Eighty-five percent of those with level IIb metastases had additional nodal disease (95% CI: 64.0-94.8), with IIa being a common denominator among all. Conclusion. Level IIb nodal metastases are relatively uncommon in previously untreated SCC of the oral cavity (6%). Furthermore, isolated level IIb nodal disease is uncommon. However, given the quality of evidence to date, it is recommended that dissection of level IIb remain the standard of care in oral cavity squamous cell cancer.",

keywords = "Level IIb, Meta-analysis, Neck dissection, Oral cavity, Squamous cell carcinoma, Submuscular recess, Systematic review",

author = "Jane Lea and Gideon Bachar and Sawka, {Anna M.} and Lakra, {Deepak C.} and Gilbert, {Ralph W.} and Irish, {Jonathan C.} and Brown, {Dale H.} and Gullane, {Patrick J.} and Goldstein, {David P.}",

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T2 - A systematic review and meta-analysis

AU - Lea, Jane

AU - Bachar, Gideon

AU - Sawka, Anna M.

AU - Lakra, Deepak C.

AU - Gilbert, Ralph W.

AU - Irish, Jonathan C.

AU - Brown, Dale H.

AU - Gullane, Patrick J.

AU - Goldstein, David P.

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N2 - Background. In this study, a meta-analysis of level IIb metastases in squamous cell carcinoma (SCC) of the oral cavity was conducted. Methods. Two independent reviewers screened abstracts and full text papers deemed potentially relevant. Data were pooled using a random intercept model. Results. In this analysis, 729 abstracts and 177 full text papers were screened (Kappa statistic 0.8 and 1.0, respectively). A total of 332 patients in 9 papers were included in the analysis. Twenty patients had level IIb metastases (mean, 6%; range, 0% to 10.4%). The pooled percentage of level IIb metastases was 6.0% (95% CI: 3.5-8.6). Only 3 patients with level IIb metastases had isolated nodal disease. Eighty-five percent of those with level IIb metastases had additional nodal disease (95% CI: 64.0-94.8), with IIa being a common denominator among all. Conclusion. Level IIb nodal metastases are relatively uncommon in previously untreated SCC of the oral cavity (6%). Furthermore, isolated level IIb nodal disease is uncommon. However, given the quality of evidence to date, it is recommended that dissection of level IIb remain the standard of care in oral cavity squamous cell cancer.

AB - Background. In this study, a meta-analysis of level IIb metastases in squamous cell carcinoma (SCC) of the oral cavity was conducted. Methods. Two independent reviewers screened abstracts and full text papers deemed potentially relevant. Data were pooled using a random intercept model. Results. In this analysis, 729 abstracts and 177 full text papers were screened (Kappa statistic 0.8 and 1.0, respectively). A total of 332 patients in 9 papers were included in the analysis. Twenty patients had level IIb metastases (mean, 6%; range, 0% to 10.4%). The pooled percentage of level IIb metastases was 6.0% (95% CI: 3.5-8.6). Only 3 patients with level IIb metastases had isolated nodal disease. Eighty-five percent of those with level IIb metastases had additional nodal disease (95% CI: 64.0-94.8), with IIa being a common denominator among all. Conclusion. Level IIb nodal metastases are relatively uncommon in previously untreated SCC of the oral cavity (6%). Furthermore, isolated level IIb nodal disease is uncommon. However, given the quality of evidence to date, it is recommended that dissection of level IIb remain the standard of care in oral cavity squamous cell cancer.

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KW - Meta-analysis

KW - Neck dissection

KW - Oral cavity

KW - Squamous cell carcinoma

KW - Submuscular recess

KW - Systematic review

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Metastases to level IIb in squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis

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