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What is the optimum operative approach for the N0 neck in patients with early mouth cancer – a review of current status

  • Mark McGurk
    Correspondence
    Corresponding author at: Head and Neck Academic Centre, University College London, Gower St, Bloomsbury, London WC1E 6BT, United Kingdom.
    Affiliations
    Head and Neck Academic Centre, University College London, Gower St, Bloomsbury, London WC1E 6BT, United Kingdom

    Department of Oral and Maxillofacial Head and Neck Surgery, University College Hospital London, 235 Euston Rd, Bloomsbury, London NW1 2BU, United Kingdom
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  • Soudeh Chegini
    Affiliations
    Head and Neck Academic Centre, University College London, Gower St, Bloomsbury, London WC1E 6BT, United Kingdom

    Department of Oral and Maxillofacial Head and Neck Surgery, University College Hospital London, 235 Euston Rd, Bloomsbury, London NW1 2BU, United Kingdom
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  • Clare Schilling
    Affiliations
    Head and Neck Academic Centre, University College London, Gower St, Bloomsbury, London WC1E 6BT, United Kingdom

    Department of Oral and Maxillofacial Head and Neck Surgery, University College Hospital London, 235 Euston Rd, Bloomsbury, London NW1 2BU, United Kingdom
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  • Stephen Y. Lai
    Affiliations
    Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Published:October 30, 2021DOI:https://doi.org/10.1016/j.bjoms.2021.08.011
      Interestingly the same question is still with us - ‘How best to manage the N0 neck’. But the focus has moved on from END vs ‘wait and see’ policy. Now we ask what is the optimal operative approach to the N0 neck. This is the topic being aired in this present review and has been prompted by a recent editorial ‘Management of the cN0 neck in early oral cancer: time to revise the guidance?’ by Panayiotis Kyzas,
      • Kyzas P.
      Management of the cN0 neck in early oral cancer: time to revise the guidance?.
      which follows a theme espoused by Vassiliou, in a EACMFS position paper ‘Management of the Clinically N0 neck in early-stage oral cancer’.
      • Vassiliou L.V.
      • et al.
      Management of the clinically N.
      The similarity in theme is understandable as the two surgeons work together.
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      References

        • Kyzas P.
        Management of the cN0 neck in early oral cancer: time to revise the guidance?.
        Br J Oral Maxillofac Surg. 2021; 59: 387-388
        • Vassiliou L.V.
        • et al.
        Management of the clinically N.
        J Craniomaxillofac Surg. 2020; 48: 711-718
        • Shah J.P.
        Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract.
        Am J Surg. 1990; 160: 405-409
        • Hernando J.
        • et al.
        Comparison of related complications: sentinel node biopsy versus elective neck dissection.
        Int J Oral Maxillofac Surg. 2014; 43: 1307-1312
        • Molstrom J.
        • et al.
        Topographical distribution of sentinel nodes and metastases from T1–T2 oral squamous cell carcinomas.
        Eur J Cancer. 2019; 107: 86-92
        • Schilling C.
        • et al.
        Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer.
        Eur J Cancer. 2015; 51: 2777-2784
        • D'Cruz A.K.
        • et al.
        Elective versus Therapeutic Neck Dissection in Node-Negative Oral Cancer.
        N Engl J Med. 2015; 373: 521-529
        • Hutchison I.L.
        • et al.
        Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort.
        Br J Cancer. 2019; 121: 827-836
        • Garrel R.
        • et al.
        Equivalence Randomized Trial to Compare Treatment on the Basis of Sentinel Node Biopsy Versus Neck Node Dissection in Operable T1–T2N0 Oral and Oropharyngeal Cancer.
        J Clin Oncol. 2020; (JCO2001661)
        • Hasegawa T.
        • et al.
        Multi-center retrospective study of the prognosis and treatment outcomes of Japanese oral squamous cell carcinoma patients with single lymph node metastasis and extra nodal extension.
        J Surg Oncol. 2018; 117: 1736-1743
      1. Soudeh Chegini CS, Evan S. Walgama,Katherine M. Yu, Krishnakumar Thankappan, Subramania Iyer, Paolo Cariati, Deepak Balasubramanian, Anastasios Kanatas, Stephen Y. Lai, Mark McGurk, Neck Failure Following Pathologically Node-Negative Neck Dissection (pN0) in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-analysis. British journal of oral and maxillofacial surgery, 2021.

        • Ganly I.
        • et al.
        Long-term regional control and survival in patients with “low-risk,” early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: the importance of tumor thickness.
        Cancer. 2013; 119: 1168-1176
        • Amit M.
        • et al.
        The origin of regional failure in oral cavity squamous cell carcinoma with pathologically negative neck metastases.
        JAMA Otolaryngol Head Neck Surg. 2014; 140: 1130-1137
        • Machiels J.P.
        • et al.
        Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
        Ann Oncol. 2020; 31: 1462-1475
        • Schilling C.
        • et al.
        Surgical consensus guidelines on sentinel node biopsy (SNB) in patients with oral cancer.
        Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. 2019; 41: 2655-2664
        • Moya-Plana A.
        • et al.
        Sentinel node biopsy in early oral squamous cell carcinomas: long-term follow-up and nodal failure analysis.
        Oral Oncol. 2018; 82: 187-194
      2. den Toom I, et al. Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience. Cancers. https://doi.org/10.3390/cancers12071783.