Bilateral versus ipsilateral neck dissection in oral and oropharyngeal cancer with contralateral cN0 neck
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HEAD AND NECK
Bilateral versus ipsilateral neck dissection in oral and oropharyngeal cancer with contralateral cN0 neck Andreas Knopf1,2 · Sven Jacob2 · Henning Bier2 · Elias Q. Scherer2,3 Received: 7 February 2020 / Accepted: 8 May 2020 © The Author(s) 2020
Abstract Objective Contralateral elective neck dissection (cEND) in oral and oropharyngeal squamous cell cancer (OC/OPC) is still a matter of debate. The current study analyzed the outcome in OC/OPC patients with/without cEND. Methods OC/OPC patients (n = 471) were diagnosed with contralateral N0 after CT/MRI-scan combined with neck ultrasound. Clinico-pathological features were analyzed using Chi-square/Fisher exact/Student’s t test. Survival rates were calculated using Kaplan–Meier and log-rank test. Prognostic variables were evaluated by Cox regression. Primary/secondary endpoints were overall/recurrence-free survival (OS/RFS). Results Pre-therapeutic imaging revealed a significantly over-staged N-status (p = 0.01), while occult contra-lateral N + was diagnosed in one patient only (0.4%). OC patients did not show differences in OS/RFS between the groups (ipsi- vs. bilateral). There was a strong tendency towards a better OS in OPC patients who underwent ipsi-lateral ND (p = 0.07). Coxregression demonstrated that only tumor recurrence was associated with a fivefold increased risk of recurrence-associated death (p
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