Primary cN0 lip squamous cell carcinoma and elective neck dissection: Systematic review and meta-analysis

Background Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. Methods A systematic review of English–language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals...

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Published in	Head & neck Vol. 37; no. 9; pp. 1392 - 1400
Main Authors	Bhandari, Kishor, Wang, Dian-can, Li, Shan-chang, Jiang, Bing-hua, Guo, Yu-xing, Koirala, Ujjwal, Du, Xiao-yan
Format	Journal Article
Language	English
Published	United States Blackwell Publishing Ltd 01.09.2015 Wiley Subscription Services, Inc
Subjects	Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery clinically node-negative (cN0) neck Disease-Free Survival elective neck dissection Elective Surgical Procedures - methods Female Humans Lip Neoplasms - mortality Lip Neoplasms - pathology Lip Neoplasms - surgery lip squamous cell carcinoma lymphatic metastasis Male Neck Dissection - methods Neoplasm Invasiveness - pathology Neoplasm Staging Prognosis Risk Assessment surgery Survival Analysis Treatment Outcome clinically node-negative (cN0) neck lip squamous cell carcinoma elective neck dissection lymphatic metastasis surgery
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ISSN	1043-3074 1097-0347 1097-0347
DOI	10.1002/hed.23772

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Abstract	Background Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. Methods A systematic review of English–language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow‐up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement for reporting systematic reviews and meta‐analysis was followed. Results The pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10–0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01–0.18). Conclusion The results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392–1400, 2015
AbstractList	Background Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. Methods A systematic review of English–language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow‐up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement for reporting systematic reviews and meta‐analysis was followed. Results The pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10–0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01–0.18). Conclusion The results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392–1400, 2015 Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic.BACKGROUNDManagement of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic.A systematic review of English-language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow-up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analysis was followed.METHODSA systematic review of English-language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow-up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analysis was followed.The pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10-0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01-0.18).RESULTSThe pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10-0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01-0.18).The results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392-1400, 2015.CONCLUSIONThe results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392-1400, 2015. Background Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. Methods A systematic review of English-language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow-up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analysis was followed. Results The pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10-0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01-0.18). Conclusion The results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392-1400, 2015 Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. A systematic review of English-language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow-up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analysis was followed. The pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10-0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01-0.18). The results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392-1400, 2015.
Author	Jiang, Bing-hua Li, Shan-chang Koirala, Ujjwal Guo, Yu-xing Bhandari, Kishor Du, Xiao-yan Wang, Dian-can
Author_xml	– sequence: 1 givenname: Kishor surname: Bhandari fullname: Bhandari, Kishor organization: Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Heilongjiang, Jiamusi City, People's Republic of China – sequence: 2 givenname: Dian-can surname: Wang fullname: Wang, Dian-can organization: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, People's Republic of China – sequence: 3 givenname: Shan-chang surname: Li fullname: Li, Shan-chang organization: Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Heilongjiang, Jiamusi City, People's Republic of China – sequence: 4 givenname: Bing-hua surname: Jiang fullname: Jiang, Bing-hua organization: Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Heilongjiang, Jiamusi City, People's Republic of China – sequence: 5 givenname: Yu-xing surname: Guo fullname: Guo, Yu-xing organization: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, People's Republic of China – sequence: 6 givenname: Ujjwal surname: Koirala fullname: Koirala, Ujjwal organization: Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Heilongjiang, Jiamusi City, People's Republic of China – sequence: 7 givenname: Xiao-yan surname: Du fullname: Du, Xiao-yan email: maxfacsurg405@gmail.com organization: Department of Plastic and Reconstructive Surgery, 2nd Affiliated Hospital of Jiamusi University, Heilongjiang, Jiamusi City, People's Republic of China
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Keywords	clinically node-negative (cN0) neck lip squamous cell carcinoma elective neck dissection lymphatic metastasis surgery
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References_xml	– reference: Thompson CF, St John MA, Lawson G, Grogan T, Elashoff D, Mendelsohn AH. Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a meta-analysis. Eur Arch Otorhinolaryngol 2013;270:2115-2122. – reference: Kocatürk S, Ozdemir N, Erkam U, Uzun H, Babila A, Oztürk E. Evaluation of occult lymph node metastasis in lower lip cancers and approach to N(0) neck metastasis [lsqb]in Turkish[rsqb]. Kulak Burun Bogaz Ihtis Derg 2002;9:41-45. – reference: Hasson O. Squamous cell carcinoma of the lower lip. J Oral Maxillofac Surg 2008;66:1259-1262. – reference: Lyall D, Grier RN. Experiences with squamous carcinoma of the lip with special reference to the role of neck dissection. Ann Surg 1960;152:1067-1070. – reference: Salgarelli AC, Sartorelli F, Cangiano A, Pagani R, Collini M. Surgical treatment of lip cancer: our experience with 106 cases. J Oral Maxillofac Surg 2009;67:840-845. – reference: Dimitrijević M, Mikić A, Petrović Z, Pendjer I, Jesić S, Trivić A. Occult metastases of oral cavity cancers [lsqb]in Serbian[rsqb]. Acta Chir Iugosl 2004;51:77-81. – reference: D'Cruz AK, Dandekar MR. Elective versus therapeutic neck dissection in the clinically node negative neck in early oral cavity cancers: do we have the answer yet? Oral Oncol2011;47:780-782. – reference: Hjortdal O, Naess A, Berner A. Squamous cell carcinomas of the lower lip. J Craniomaxillofac Surg 1995;23:34-37. – reference: Bilkay U, Kerem H, Ozek C, et al. Management of lower lip cancer: a retrospective analysis of 118 patients and review of the literature. Ann Plast Surg 2003;50:43-50. – reference: Lucas R. Pathology of tumours of the oral tissues. Edinburg, UK: Churchill Livingstone; 1976. p 142. – reference: Koç C, Akyol MU, Celikkanat S, Cekiç A, Ozdem C. Role of suprahyoid neck dissection in the treatment of squamous cell carcinoma of the lower lip. Ann Otol Rhinol Laryngol 1997;106:787-789. – reference: Dediol E, Luksić I, Virag M. Treatment of squamous cell carcinoma of the lip. Coll Antropol 2008;32 Suppl 2:199-202. – reference: Teichgraeber JF, Clairmont AA. The incidence of occult metastases for cancer of the oral tongue and floor of the mouth: treatment rationale. Head Neck Surg 1984;7:15-21. – reference: Weiss MH, Harrison LB, Isaacs RS. Use of decision analysis in planning a management strategy for the stage N0 neck. Arch Otolaryngol Head Neck Surg 1994;120:699-702. – reference: Hosal IN, Onerci M, Kaya S, Turan E. Squamous cell carcinoma of the lower lip. Am J Otolaryngol 1992;13:363-365. – reference: Picoto Ada S, Oliveira Ada S, Verde SF, Martins O. Management of squamous-cell carcinoma of the lip. J Dermatol Surg Oncol 1980;6:562-566. – reference: Shah JP. Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. 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Snippet	Background Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. Methods A... Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. A systematic review of... Background Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. Methods A... Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic.BACKGROUNDManagement of...
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SubjectTerms	Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery clinically node-negative (cN0) neck Disease-Free Survival elective neck dissection Elective Surgical Procedures - methods Female Humans Lip Neoplasms - mortality Lip Neoplasms - pathology Lip Neoplasms - surgery lip squamous cell carcinoma lymphatic metastasis Male Neck Dissection - methods Neoplasm Invasiveness - pathology Neoplasm Staging Prognosis Risk Assessment surgery Survival Analysis Treatment Outcome
Title	Primary cN0 lip squamous cell carcinoma and elective neck dissection: Systematic review and meta-analysis
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