Predictors of Occult Metastasis and Prognostic Factors in Patients with cN0 Oral Cancer Who Underwent Elective Neck Dissection.

Simple Summary: Neck control is a particularly important prognostic factor, and the diagnosis of neck metastasis at the initial examination is important for oral squamous cell carcinoma (OSCC). A pathologically negative neck does not guarantee future recurrence after preventive neck dissection in patients who are clinically node-negative (cN0). We hypothesized that some factors predict poor prognosis regardless of cN0 preventive neck dissection. Among 86 patients with OSCC, occult metastases were observed in 9 (10.5%), and the prognosis of these patients was local recurrence in 6 (7.0%) and neck recurrence in 9 (10.5%). The neutrophil-to-lymphocyte ratio (NLR) and vascular invasion are good markers for detecting OM. A Cox multivariable analysis identified two independent predictors of overall survival: pathologic node and laterality of END. An independent predictive factor for disease-free survival, the surgical margin, was also identified in this study. Elective neck dissection (END) is recommended for the management of patients with oral squamous cell carcinoma (OSCC) because of the risk of occult metastasis (OM). We hypothesized that some factors predict poor prognosis regardless of a cN0 END. This study aimed to investigate the predictors of OM and prognostic factors in patients with cN0 OSCC who underwent supraomohyoid neck dissection (SOHND). A retrospective cohort study design was created and implemented. The primary predictive variables in this study were OM and risk factors for poor prognosis after SOHND. A Cox proportional hazard model was used to adjust for the effects of potential confounders on the risk factors for poor prognoses. Among 86 patients with OSCC, OMs were observed in 9 (10.5%). The neutrophil-to-lymphocyte ratio (NLR) and vascular invasion are good markers for detecting OM. A Cox multivariable analysis identified two independent predictors of overall survival: pathologic node (pN) and laterality of END. An independent predictive factor for disease-free survival, the surgical margin, was also identified in this study. According to the pN classification, pN1 patients had a worse survival rate than pN2 patients. Therefore, in the case of pN1, regardless of being cN0, additional adjuvant therapy may be necessary. [ABSTRACT FROM AUTHOR]