Study title

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

journal

Oral Oncology

study year

2011

QUESTION

Is there a difference between elective neck dissection (END) and therapeutic neck dissection (TND)/ observation in the management of the clinical N0 neck in oral carcinoma patients?

Study DESIGN

Meta-analysis (n = 4)

STUDY GROUPS

Elective neck dissection (END) vs Observation/therapeutic neck dissection (OBS)

Population

Oral cavity squamous cell carcinoma with clinical N0 neck (no clinical/radiological evidence of neck node metastasis)

Inclusion criteria

END group: primary neck dissection at time of treatment of primary tumour

OBS group: treatment of primary tumour only with neck under close observation during follow-up and TND only performed on detection of neck node metastasis

Exclusion criteria

N/A

Follow-up

Variable (20 – 36 months)

Primary endpoint(s)

Disease-specific death: risk reduction with END vs OBS (RR = 0.57, 95% CI 0.36 – 0.89, p=0.0014)

Secondary endpoint(s)

Primary site recurrence (END: 8-12%; OBS: 9-14%)

Nodal recurrence or metastasis (END: 8-30%; OBS: 37-58%)

Occult metastasis (END: 21-49%; OBS: N/A)

Overall deaths (END: 12-30%; OBS: 11-42%)

Weblink

https://ac.els-cdn.com/S1368837511001059/1-s2.0-S1368837511001059-main.pdf?_tid=6d672476-fa43-4c0e-b307-80655f323673&acdnat=1526383521_8c9e6f28ba35f013093ab1e6ecb5abef

Brief summary

Overall reduction in risk of disease-specific death of elective neck dissection versus observation/therapeutic neck dissection

Authors

Fasunla et al

Department of Otolaryngology, Head and Neck Surgery, Phillipps-University of Marburg, Germany