Dear Editor,
The debate regarding neck treatment for early-stage oral cavity squamous cell carcinoma (SCC) with negative necks (N0) have lasted for many decades because up till now there is no preoperative investigation to be 100% sure that nodal micro-metastasis (which is common in oral cavity SCC) does not exist, even with the use of preoperative PET/CT or detection of micro-RNA molecules from sentinel lymph nodes [1, 2]. A recent study by Majumdar et al. [3] showed that micro-metastasis and isolated tumour cells were presented in 9% of cases of early-stage oral cavity SCC.
Our meta-analysis (that included 24 articles both retrospective and prospective) showed that elective neck dissection for patients with early-stage oral SCC with N0 neck offered better regional control than watchful waiting with subsequent better 5-year survival rate [4].
Another meta-analysis by Massey et al. [5] showed similar results, hence neck treatment is essential in early-stage oral cavity SCC particularly for oral tongue and floor of the mouth.
References
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Ahmed, A.N.A. In reply to the letter to the editor regarding “Micro-metastasis and Isolated tumour cells: The span between Elective Neck Dissection versus Neck Observation in Early oral cancer”. Eur Arch Otorhinolaryngol 277, 2661 (2020). https://doi.org/10.1007/s00405-020-06148-8
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DOI: https://doi.org/10.1007/s00405-020-06148-8