Artikel
Does Timing of Neck Dissection Influence Prognosis in Oral and Pharyngeal Cancer Treated by Enoral/Transoral Resection?
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Veröffentlicht: | 7. September 2006 |
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Gliederung
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Discontinuous treatment of primary tumor and neck increasingly replaces block and commando resections. Within discontinuous treatment neck dissection may be performed simultaneous with primary tumor resection or with a gap of some days to a few weeks. The latter practice is preferred if development of a mucocutaneous fistula is feared. In this retrospective study both regimes were compared.
The records of 347 patients (including 41 women) were reviewed. 40,6% tumors had their origin from oral cavity, 45,3% from oropharynx and 14,1% from hypopharynx.
All primary tumors were resected by means of enoral or transoral surgery. Elective neck dissection was performed in 29,7%.
In 69,2% tumor surgery and neck dissection were carried out simultaneously (group 1), in 30,8% sequentially (group 2).
Recurrence free five year survival rates were 60,3% in group 1 und 56,9% in group 2 showing no difference in logrank test (p=0,33). Regional recurrencies were observed in 7,9% in group 1 and in 9,3% in group 2. Multivariate cox regression failed to identify timing of neck dissection as significant prognostic factor, too.
It is to conclude that the concept of sequential neck dissection has no oncologic disadvantages when otherwise the danger of fistula development exists.