Depth of tumor infiltration as a prognosticator in pT1-2 cN0 oral squamous cell carcinoma thereby need for elective neck dissection – A meta-analysis

Abstract

Aim: The aim of the study is to identify the cutoff value for depth of infiltration that predicts the risk of lymph node metastasis in the neck in surgically treated patients affected by pT1/pT2 cN0 oral squamous cell carcinoma (OSCC). Materials and Methods: Meta-analysis of six articles, including 938 patients, was performed from a PubMed search of the last 15 years. Results: The mean depth of infiltration in N0 neck was 4.42 mm, standard deviation (SD) 0.66 (95% confidence interval [CI], 3.89–4.95), while the mean depth of infiltration in N+ neck was 6.95 mm, SD 1.36 (95% CI, 5.86–8.04). One sample t-test done to analyze the level of significance between the cutoff depth of infiltration for N0 and N+ was found to be significant,P= 0.002. Receiver operating characteristic analysis was done to find the cutoff depth of infiltration in all N0 necks which was 4.5 mm with odds ratio 9.32, sensitivity of 84.7% in N+ necks which makes elective neck dissection an important surgical option for good prognosis of OSCC. Conclusion: Tumor infiltration depth is an important prognosticator in pT1/pT2 cN0 necks. Tumors with depth of infiltration >4.5 mm radiologically or clinically should undergo an elective neck dissection to improve the prognosis of OSCC.

Keywords

• hnscc
• ln dissection
• neck dissection
• oral squamous cell carcinoma
• prognosis
• t stage