gms | German Medical Science

77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

Does Timing of Neck Dissection Influence Prognosis in Oral and Pharyngeal Cancer Treated by Enoral/Transoral Resection?

Meeting Abstract

  • corresponding author presenting/speaker Frank Waldfahrer - Department of Otorhinolaryngology, Head & Neck Surgery, University of Erlangen Medical School, Erlangen, Germany
  • Ercan Guerlek - Department of Otorhinolaryngology, Head & Neck Surgery, University of Erlangen Medical School, Erlangen, Germany
  • Georgios Psychogios - Department of Otorhinolaryngology, Head & Neck Surgery, University of Erlangen Medical School, Erlangen, Germany
  • Heinrich Iro - Department of Otorhinolaryngology, Head & Neck Surgery, University of Erlangen Medical School, Erlangen, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno076

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2006/06hno076.shtml

Published: September 7, 2006

© 2006 Waldfahrer et al.
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Outline

Text

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.