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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1483921
This article is part of the Research Topic Challenges to Research on Oral Potentially Malignant Disorders and Oral Cancer View all 4 articles
Algorithm-Based Analysis of Lymph Node Dissection Strategies and Survival Outcomes in Primary Oral Squamous Cell Carcinoma
Provisionally accepted
Dr. Dr. Andreas Vollmer 1*
Babak Saravi 2
Alexander Kübler 1
Urs Müller-Richter 1 Anna Winter 3 Simon Nager 1 Marius Hörner 1
Sebastian Gubik 1
Stefan Hartmann 1- 1 Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Würzburg, Germany
- 2 Department of Orthopedics and Trauma Surgery, Freiburg University Medical Center, Freiburg, Germany
- 3 Julius Maximilian University of Würzburg, Würzburg, Bavaria, Germany
Recent advancements in treatment approaches for oral squamous cell carcinomas (OSCCs) necessitate a reevaluation of neck dissection techniques and their impact on patient outcomes and morbidity. This retrospective study of 250 OSCC patients recruited between 2017-2022 examined the association between neck dissection techniques and survival metrics. Our cohort, drawn from a primary OSCC surgery population at our clinic, provided a rich dataset encompassing demographics, clinical parameters, and detailed surgical records. Two neck dissection techniques were analyzed: the Supraomohyoid Selective Neck Dissection (SND), which targets lymph nodes at Levels I-III, and Other Dissections (OD), which involve a more extensive extraction including Levels IV and V. Kaplan-Meier survival curves and Cox proportional hazards models assessed the influence of lymph node dissection on postoperative outcomes. Findings indicated that each additional lymph node removed was associated with a 0.289-day increase in hospitalization (p = 0.002), yet no significant link was found between dissection techniques or total lymph node extraction count and survival metrics. Levels I to III emerged as critical areas with the highest likelihood of yielding tumour-positive lymph nodes, emphasizing the significance of these levels.The study suggests that more extensive dissection does not necessarily confer survival benefits, highlighting the importance of strategic surgical focus and the potential for tailored interventions that prioritize disease-specific lymph node levels to optimize patient recovery and prognosis.
Keywords: Head and Neck Neoplasms, Neck Dissection, Lymph node yield, Survival Rate, Kaplan-Meier Estimate, proportional hazards model
Received: 21 Aug 2024; Accepted: 01 Apr 2025.
Copyright: © 2025 Vollmer, Saravi, Kübler, Müller-Richter, Winter, Nager, Hörner, Gubik and Hartmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dr. Dr. Andreas Vollmer, Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Würzburg, Germany
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