Background: Supraglottic squamous cell carcinoma (SCC) is a significant portion of head and neck cancers, with the management of clinically negative necks (cN0) through selective neck dissection (SND) being debated due to potential morbidities and low metastasis rates in levels IIb and IV. Methods: This study is a retrospective, multicenter examination of the potential feasibility of limited neck dissection (LND), including only levels IIa and III in cN0 supraglottic SCC patients. It analyzed occult metastasis rates and explored relapse occurrences alongside potential predictors of lymph node metastasis. Results: Among 425 patients, predominantly male (85.6%) with a mean age of 63 years, the occult metastasis rate was 28.9%, and 13.7% experienced relapses during a mean follow‐up of 52 months. Advanced clinical stage, higher grading, and other risk factors emerged as predictors of occult lymph node metastasis at level IIb. Conclusions: The study supports LND potential feasibility for cN0 supraglottic SCC, suggesting level IIb dissection can be omitted in specific early‐stage cases to reduce morbidity without affecting outcomes.

Despite advancements in multidisciplinary care, oncologic outcomes of oral cavity squamous cell carcinoma (OSCC) have not substantially improved: still, one-third of patients affected by stage I and II can develop locoregional recurrences. Imaging plays a pivotal role in preoperative staging of OSCC, providing depth of invasion (DOI) measurements. However, locoregional recurrences have a strong association with adverse histopathological factors not included in the staging system, and any imaging features linked to them have been lacking. In this study, the possibility to predict histological risk factors in OSCC with high-frequency intraoral ultrasonography (IOUS) was evaluated. Thirty-four patients were enrolled. The agreement between ultrasonographic and pathological DOI was evaluated, and ultrasonographic margins’ appearance was compared to the Brandwein-Gensler score and the worst pattern of invasion (WPOI). Excellent agreement between ultrasonographic and pathological DOI was found (mean difference: 0.2 mm). A significant relationship was found between ultrasonographic morphology of the front of infiltration and both Brandwein-Gensler score ≥ 3 (p < 0.0001) and WPOI ≥4 (p = 0.0001). Sensitivity, specificity, positive predictive value, and negative predictive value for the IOUS to predict a Brandwein-Gensler score ≥3 were 93.33%, 89.47%, 87.50%, and 94.44%, respectively. The present study demonstrated the promising role of IOUS in aiding risk stratification for OSCC patients.

Background/Objectives: The role of induction chemotherapy (IC) in advanced oral cavity squamous cell carcinoma (OCSCC) remains controversial. This study evaluated patient-level changes in primary-tumour and cervical nodal dimensions, subsequent definitive treatment, and survival after curative-intent IC. Methods: We retrospectively analysed 38 patients with primary, non-metastatic OCSCC treated with curative-intent IC between 2009 and 2024. Recurrent disease, second primary tumours, non-squamous histology, non-oral primary sites, baseline metastatic disease, direct chemoradiotherapy, and palliative systemic treatment were excluded. A prespecified simplified unidimensional radiological analysis was performed. The maximum axial primary-tumour diameter, the largest baseline cervical node, and total recorded nodal burden were compared before and after IC. Baseline nodes absent after IC were coded as 0 mm only when disappearance was confirmed on post-IC anatomical imaging. The overall survival (OS) was measured from IC initiation. Results: Primary-tumour measurements were evaluable in 25 patients. Median diameter decreased from 55.0 to 46.0 mm, corresponding to a median change of −13.5% (p = 0.049). The largest baseline node was evaluable in 19 patients and decreased from 17.0 to 13.0 mm, a median change of −16.7% (p = 0.004). Total nodal burden changed by a median of −8.3% (p = 0.257). Primary-tumour change did not differ significantly from largest-node change (p = 0.073) or total nodal-burden change (p = 0.860). TP and TPF showed no difference in primary-tumour change (p = 0.954). During a median follow-up of 40.4 months, 16 patients died. Median OS was 45.1 months and 5-year OS was 35.6%. Conclusions: IC produced heterogeneous, generally modest radiological changes. The largest baseline node decreased significantly, whereas total nodal burden did not. These data do not establish the superiority of one regimen or a causal survival benefit from surgery and should be considered hypothesis-generating.