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Esophageal Cancer Research and Treatment / Head and Neck Cancer Studies · Journal article
South Russian Journal of Cancer · September 6, 2026
Well-designed and adequately powered for the question it asks.
This population-based retrospective cohort study of 204 patients with stage T1–2N0M0 oral cavity cancer found that radical surgery with prophylactic elective neck dissection was associated with superior cancer-specific survival compared to omission of regional lymph node treatment (HR 2.90) or definitive radiotherapy alone (HR 3.24). After multivariable adjustment for stage, age, sex, morphology, residence, and calendar period, surgery with adjuvant radiation did not differ significantly from surgery with elective neck dissection (HR 1.63, p=0.276), supporting a combined-modality approach.
Population-based retrospective cohort study. 204 patients with cT1–2N0M0 oral cavity cancer from population-based registry in Arkhangelsk Oblast and Nenets Autonomous Okrug.. Intervention: Four treatment strategies: (1) radical surgery of primary tumor with prophylactic neck lymph node dissection (n=63); (2) radical surgery with neck dissection followed by adjuvant radiation/chemoradiation (n=38); (3) radiation/chemoradiatio…. Compared with: Reference group: surgery with elective neck dissection (n=63).. n = 204. Arkhangelsk Oblast and Nenets Autonomous Okrug, Russian Federation..
5-year cancer-specific survival rate in overall cohort 70.8% (95% CI 63.2–77.1%) Omission of regional lymph node treatment associated with 2.9-fold increased death risk versus elective neck dissection (HR 2.90; 95% CI 1.01–8.37; p=0.049) Definitive radiotherapy as standalone modality associated with 3.24-fold increased death risk (HR 3.24; 95% CI 1.42–7.38; p=0.005)
Stage II disease (HR 2.72; p=0.013) and age 50–69 years (HR 1.99; p=0.023) were independent adverse prognostic factors
For clinicians treating early-stage oral cavity cancer (Stage I–II, N0), this evidence supports elective neck dissection combined with primary tumor resection as the optimal strategy. Omission of regional lymph node treatment or reliance on radiotherapy alone as definitive treatment are associated with substantially higher mortality risk and should be avoided in routine practice, except where medical contraindications exist.
Rigorous population-based retrospective cohort study with multivariable adjustment comparing four treatment strategies in localized oral cavity cancer, demonstrating significantly improved survival with elective neck dissection versus omission or radiotherapy alone.
As stated by the source record.
Quoted from the source exactly as published.
For clinicians treating early-stage oral cavity cancer (Stage I–II, N0), this evidence supports elective neck dissection combined with primary tumor resection as the optimal strategy. Omission of regional lymph node treatment or reliance on radiotherapy alone as definitive treatment are associated with substantially higher mortality risk and should be avoided in routine practice, except where medical contraindications exist.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Purpose of the study. To evaluate the impact of different management strategies for regional nodal metastases on survival in patients with localized oral cavity cancer (cT1–2N0M0), based on data from the population-based cancer registry of Arkhangelsk Oblast and Nenets Autonomous Okrug (PCR AO and NAO) over the period 2010–2024. Patients and methods. A population-based retrospective cohort study was conducted including 204 patients from the Population-Based Cancer Registry of the Arkhangelsk Region and the Nenets Autonomous Okrug. According to the treatment strategy chosen, patients were allocated to four groups: 1) radical surgery of the primary tumor with prophylactic neck lymph node dissection (n = 63); 2) radical surgery of the primary tumor with neck lymph node dissection followed by adjuvant radiation/chemoradiation therapy (n = 38); 3) radiation/chemoradiation therapy as a standalone treatment (n = 69); 4) radical surgery directed to the primary tumor only, without regional lymph node treatment (n = 34). Survival analysis was performed using the Kaplan–Meier method, the log-rank test, and the Cox proportional hazards regression model. Results. The 5‑year cancer-specific survival rate in the overall cohort was 70.8 % (95 % CI, 63.2–77.1 %). After adjustment for stage, age, sex, morphology, place of residence, and calendar period, the surgery group with elective neck dissection demonstrated the most favorable prognosis. Compared with this reference group, omission of regional lymph node treatment was associated with a 2.9‑fold increase in the risk of death (HR = 2.90; 95 % CI, 1.01–8.37; p = 0.049), while definitive radiotherapy as a standalone modality was associated with a 3.24‑fold increase (HR = 3.24; 95 % CI, 1.42–7.38; p = 0.005). The risk in the adjuvant radiotherapy group did not differ significantly from that in the reference group (HR = 1.63; p = 0.276). Stage II disease (HR = 2.72; p = 0.013) and age 50–69 years (HR = 1.99; p = 0.023) were independent adverse prognostic factors. Conclusion. The results of this population based study demonstrate that radical surgery of the primary tumor combined with prophylactic neck lymph node dissection is the optimal treatment strategy for patients with Stage I–II oral cavity cancer. Omission of regional lymph node treatment or the use of radiation therapy as a standalone method in routine clinical practice are associated with a statistically significant increase in the risk of disease specific mortality.
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