Tesis

Rekurensi Regional Karsinoma Sel Skuamosa Lidah Stadium Awal dengan Diseksi Leher Elektif vs Sentinel Lymph Node Biopsy = Regional Recurrence of Early-Stage Tongue Squamous Cell Carcinoma with Elective Neck Dissection vs Sentinel Lymph Node.

Pendahuluan: Karsinoma sel skuamosa (KSS) lidah adalah jenis kanker rongga mulut terbanyak yang bersifat progresif dengan kemungkinan metastasis limfatik yang tinggi. Pada pasien KSS lidah stadium awal dengan status N0 dapat dilakukan tatalaksana diseksi leher elektif (END) atau sentinel lymph node biopsy (SLNB). Penelitian ini dilakukan untuk menilai tingkat kejadian rekurensi lokoregional pada pasien KSS lidah stadium awal yang mendapatkan tata laksana END dibandingkan dengan SLNB. Metode: Peneliti melakukan penelusuran sistematis yang didaftarkan diPROSPERO secara daring menggunakan kata kunci (tongue neoplasm OR tongue cancer) AND (early stage OR N0) AND (neck dissection OR elective neck dissection OR selective neck dissection) AND (biopsy OR sentinel lymph node biopsy) pada basis data Cochrane, EBSCOhost, PubMed, dan ProQuest pada bulan Agustus – November 2024. Hasil studi ditelaah kritis menggunakan Prognostic Critical Appraisal Sheet yang dikeluarkan oleh Oxford Centre for Evidence-Based Medicine dan dinilai risiko biasnya menggunakan ROBINS-I. Hasil: Penelusuran menghasilkan 5 studi yang terdiri atas 2 studi prospektif dan 3 studi retrospektif. Semua studi memiliki validitas tinggi dengan risko bias rendah pada 2 studi prospektif dan moderat pada 3 studi retrospektif. Rekurensi regional pada END didapatkan berkisar antara 4,87% - 17,1%, sedangkan pada pasien yang menerima tata laksana SLNB adalah sebesar 5,1 2% - 20%. Kesimpulan: Tindakan diseksi leher elektif (END) dan sentinel lymph node biopsy (SLNB) pada pasien karsinoma sel skuamosa lidah stadium awal tidak menunjukkan perbedaan signifikan terhadap kejadian rekurensi regional.


Introductiom: Squamous cell carcinoma (SCC) of the tongue is the most common type of oral cavity cancer, characterized by its progressive nature and a high propensity of occult lymphatic metastasis. In patients with early-stage SCC of the tongue with an N0 status, management options include elective neck dissection (END) or sentinel lymph node biopsy (SLNB). This study aims to evaluate the incidence of locoregional recurrence in early-stage SCC patients receiving END compared to those undergoing SLNB. Method: The researchers conducted a systematic review registered with PROSPERO, using the keywords (tongue neoplasm OR tongue cancer) AND (early stage OR N0) AND (neck dissection OR elective neck dissection OR selective neck dissection) AND (biopsy OR sentinel lymph node biopsy) across databases including Cochrane, EBSCOhost, PubMed, and ProQuest from August to November 2024. Study results were critically assessed using the Prognostic Critical Appraisal Sheet from the Oxford Centre for Evidence-Based Medicine, with bias risk evaluated using the ROBINS-I tool. Results: The search yielded five studies, comprising two prospective studies and three retrospective studies. All studies demonstrated high validity, with low bias risk in the two prospective studies and moderate risk in the three retrospective studies. The regional recurrence rates for END ranged from 4.87% to 17.1%, while recurrence in patients receiving SLNB ranged from 5.12% to 20%. Conclusion: In conclusion, elective neck dissection (END) and sentinel lymph node biopsy (SLNB) in patients with early-stage squamous cell carcinoma of the tongue do not show significant differences in regional recurrence rates.