Cancer Clinical Trial
Official title:
Prognostic Value of Tumor Thickness of Buccal Mucosa Squamous Cell Carcinoma on the Incidence of Nodal Metastasis in the Neck: A Cohort Study
Does the tumor thickness value of buccal squamous cell carcinomas, predict cervical nodal metastasis in clinically and radio-graphical neck negative (N0) thus sparing such patients unnecessary surgical procedures and it's associated morbidities? The aim of the study is to evaluate the prognostic value of tumor thickness cut off 4 mm in predicting cervical nodal metastases in a population of Egyptian patients presenting with Buccal Squamous Cell Carcinoma. The hypothesis is that patients with tumor thickness less than 4 mm will present with significantly less cervical nodal metastasis.
Patients will be recruited from the outpatient clinics of Al Monofia university hospital,
Cairo University Hospital and National Cancer Institute. Patients who fits the inclusion
criteria and are motivated and consent to enter the study will be included. Patient
recruitment will continue until the target sample size is reached.
Patients data will be collected including personal data, medical history, family history, and
classification of the tumor according to the TNM classification system. Patients will be
assessed preoperatively with a transcutaneous high frequency probe ultrasound to measure the
maximal tumor thickness in millimeters using a 10MHz superficial probe and the lymph nodes in
the neck region. In addition to clinical examination and palpation of the neck lymph nodes.
Patients will then undergo tumor resection surgery with adequate safety margins under GA with
nasotracheal intubation. Selective neck dissection will then be performed. The specimens will
be submitted for histopathological examination.
Patients will receive standard post operative care based on the recommendation of the
oncologist. Adjunct chemo or radiotherapy will be administered when deemed necessary. Wound
care and dressings will be administered as needed.
Patients will be categorized into two groups based on the tumor thickness (exposure).
For the primary outcome, the data source will be the measurement of tumor depth based on
Berslow method as discussed in the review of literature, obtained from ultrasonography and
recorded in millimeters.Tumor width recorded in (mm) will also be obtained from the
ultrasonography as it may be a source of confounders. Further, histological grade of the
lesion will also be recorded.
Two confounding factors are highlighted and may be sources of bias and attempt to control for
them in the statistical analyses will be made.
Appropriate statistical methods will be used after collection of the data and sources of
confounders will be controlled for during analyses in subgroup An attempt to control for
tumor width and histological grade in subgroup analyses
All data will be entered electronically. Patients' files are to be stored in numerical order
and stored in secure and accessible place. All data will be maintained in storage for 1 year
after completion of the study. Data monitoring committee is independent from the sponsor and
competing interest.
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