Author(s)
Whitney Jin, BA
Rahul Sharma, MD
Sindhura Sridhar, BS
Patrick Tassone, MD
Ramez Philips, MD
Michael Charles Topf, MD MSCI
Affiliation(s)
Vanderbilt University Medical Center;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to identify trends in incidence of elective neck dissection over time.
Objectives: A landmark paper published in 2015 found that elective neck dissection (END) improved overall survival (OS) compared to salvage therapeutic neck dissection in patients with clinically node negative oral cavity squamous cell cancer (OCSCC). The objective of this study is to determine the incidence of END among patients with newly diagnosed early stage OCSCC using the National Cancer Database (NCDB).
Study Design: NCDB study.
Methods: Patients with previously untreated, clinical T1/T2 N0 OCSCC who underwent definitive surgical resection between 2004-2020 were queried from the NCDB. Incidence of END was examined over time. The impact of END on OS was compared using Cox proportional hazards model to assess for confounding variables.
Results: Among 28,587 patients with early stage OCSCC, 10,650 (37%) patients received an END. Of the patients who received END, 20.32% had occult nodal metastases. Prior to 2010, 30% of patients with early stage OCSCC received an END. This rate increased to 36% between 2011-2025, 46% between 2016-2019, and 50% after 2020. Incidence of END increased over time (OR = 1.07, 95% CI 1.07-1.08). Patients with T2 disease were more likely to undergo END (OR = 3.49, 95% CI 3.31-3.68). Patients who underwent END had improved OS on Cox proportional hazards model after controlling for year of surgery, age, race, gender, grade, T stage, Charleston-Deyo Comorbidity Index, and adjuvant radiation (HR = 0.95, 95% CI 0.91-0.99, p = 0.012).
Conclusions: On a national level, there has been an increase in END for early stage OCSCC over the past 16 years.