Survival Outcomes of Neck Management(s) Approaches in OSCC: A Systematic Review and Meta-analysis
摘要
Oral squamous cell carcinoma (OSCC) is a growing concern due to its poor prognosis, treatment failures, andnoncompliance. Since there is significant variation in neck involvement of OSCC patients, the aim here is to identify current practicesand gaps in OSCC management strategies across various cases with distinct clinical presentations.
Methodology:The literature was accessed from various sources such as PubMed, MEDLARS Online (MEDLINE), CINAHL, Web ofScience, Global Index Medicus, CENTRAL, AMED, and Embase from inception till 31 August 2024. The survival outcomes of variousneck treatments were screened and the data was extracted using the PRISMA strategy. Following this, the data was pooled using arandom effects model to analyse the effect size of interventions pertaining to overall survival, disease-free survival, 5-year/2-yearsurvival, and recurrences achieved through neck management(s). The risk of bias assessment was performed using the QUIPS tool.Heterogeneity was assessed by chi-square and I2 statistics. All the statistical analysis was conducted using STATA 18.0.
Results:The initial search of 1746 records were screened and filtered to achieve an outcome of 25 studies for qualitative synthesis,out of which six studies were eligible for meta-analysis. The pooled risk ratio for the analysis was statistically significant (RR=1.73) at95% CI. The I2 test of heterogeneity was also significant (85.3%, p=0.000).
Conclusion:The meta-analysis identified the need for customized treatment plans based on tumor biology and patient-specificfactors, with surgery as the mainstay of treatment to maximize survival results. However, the wait and watch approach requiresevidence in patients with N0 necks through more cohort studies and trials for evidence synthesis.