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

• 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
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.23772

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