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The role of unconventional lymph node metastasis in neck recurrence among patients with tongue cancer

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Abstract

Objectives

Statistics on the rate of unconventional lymph node metastases (ULNM) at the time of one-stage radical surgery in tongue cancer patients. To assess whether an extended neck dissection group with additional removal of ULNs has a lower rate of neck recurrence compared to the traditional neck dissection group.

Materials and methods

A total of 336 patients with TSCC who underwent radical surgery were recruited and underwent traditional or extended neck dissection. Compared to traditional neck dissection, the aim of extended neck dissection is designed to additional resect ULNs.

Results

In total, 180 patients underwent extended neck dissection, while 156 underwent traditional neck dissection. The incidence of ULNM was 11.67% (21/180) in patients treated with extended neck dissection. The incidence of ipsilateral neck recurrence was 9.49% and 0.56% in patients who underwent traditional and extended neck dissection, respectively (p = 0.0001).

Conclusions

Extended neck dissection is effective for preventing neck recurrence in TSCC patients with ULNs.

Clinical relevance

ULNM may be the main cause of neck recurrence after neck dissection in patients with tongue cancer. A better prognosis may be achieved by additional resection of ULNs on the basis of traditional neck dissection.

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Data availability

The data generated in this study are available upon request from the corresponding author.

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Funding

This work was supported by the Scientific Research Launch Project for new employees of the Second Xiangya Hospital of Central South University (Kun Wu), the Youth Program of the Natural Science Foundation of Hunan Province (2021JJ40877, Kun Wu), and China Postdoctoral Science Foundation (2023M732285).

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, Renmin Road, No. 139, Changsha, 410000, China

    Kun Wu, Bowen Dai & Hanjiang Wu

  2. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China

    Kun Wu

  3. Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, 410000, China

    Keke Zhu

Authors
  1. Kun Wu
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  2. Bowen Dai
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Contributions

Conceptualization, HW, KW, and BD; methodology, HW, KW, and BD; figure preparation, KW, HW, and KZ; quality control and algorithms, KW and BD; writing original draft preparation, KW and BD; writing, review, and editing, KW, BD, and KZ; supervision, HW. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hanjiang Wu.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Ethical approval was given by The Institutional Review Board of the Second Xiangya Hospital (approval number 2011210). All patients have received and signed a written informed consent form and patient information.

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No conflicts of interest.

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Kun Wu and Bowen Dai contributed equally to the work and should be regarded as co-first authors.

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Wu, K., Dai, B., Zhu, K. et al. The role of unconventional lymph node metastasis in neck recurrence among patients with tongue cancer. Clin Oral Invest 28, 13 (2024). https://doi.org/10.1007/s00784-023-05421-4

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