Do Patients With T1N0M0 Oral Tongue Squamous Cell Carcinoma (OTSCC) Need Neck Dissection? A Study Based on SEER Database.

OBJECTIVE

To identify T1N0M0 oral tongue squamous cell carcinoma (OTSCC) patient subgroups benefiting most from neck dissection (ND) based on the SEER database.

METHODS

Patients with T1N0M0 OTSCC were identified from the SEER database. Propensity score-matching (PSM) was utilized to balance baseline characteristics between ND and non-ND groups. Survival differences between these groups were compared using Kaplan-Meier (K-M) analysis and log-rank tests. Additionally, a multivariable Cox regression model was applied to the pre-matched cohort to identify independent prognostic factors.

RESULTS

In total, 2426 cases were included. In the multivariable model adjusted for key prognosticators, ND was an independent factor associated with significantly improved OS and DSS. After PSM, 1702 well-balanced patients were analyzed. Subgroup analyses based on tumor characteristics revealed that favorable survival outcomes associated with ND were predominantly observed in patients with tumor sizes 11-20 mm and those with moderate or poor/undifferentiated differentiation. For patients with small tumors (1-10 mm) or well-differentiated histology, survival outcomes were comparable between the ND and observation groups.

CONCLUSION

ND was associated with improved survival for T1N0M0 OTSCC patients with 11-20 mm tumors and moderate/poor/undifferentiated differentiation. For patients with smaller tumors (1-10 mm) or well-differentiated histology, the observation strategy had demonstrated survival benefits comparable to ND.