![]() ![]() On the other hand, the defenders of surveillance draw attention to possible sequelae due to the neck dissection. 9 showed that SND for patients with early stage oral cavity SCC had a higher disease-free survival from 45.9% to 69.5% when compared to the watchful waiting method. 8 In addition, in a prospective, randomized study, D’Cruz et al. 6,7 Undiagnosed lymph node disease increased the risk of recurrence and decreased survival at 5 years from 82% to 53%. Those who favor selective neck dissection base their arguments on apparently better oncological outcomes. In previous decades, for patients with T1/T2 N0 oral squamous cell carcinoma, the discussion about neck management was polarized between selective neck dissection (SND) and surveillance with strict observation of the patient's evolution (“watchful waiting”), reserving neck dissection only for those patients who would develop metastatic lymph node disease during followup. 3,4 Therefore, neck management plays a key role in therapeutic planning. 1,2 Regarding the oral cavity, primary tumors in the early stage (T1, T2), without clinical evidence of neck disease (cN0), may present an incidence of occult metastases ranging from 10% to 50%. The presence of cervical metastases is considered to be the main factor for poor prognosis in patients with squamous cell carcinomas (SCC) of the head and neck. Patients with early-stage oral cavity squamous cell carcinoma undergoing sentinel lymph node biopsy presented better late results of general quality of life, mainly regarding appearance and chewing, when compared to patients submitted to selective neck dissection. The evaluation of the questionnaires showed a late worsening of the domains appearance ( p = 0.035) and chewing ( p = 0.041), as well as a decrease of about 10% of general quality of life ( p = 0.025) in patients undergoing selective neck dissection in comparison to those undergoing sentinel lymph node biopsy. All patients answered the University of Washington quality of life questionnaire. MethodsĬross-sectional study including 24 patients, after a 36 month follow-up, 15 of them submitted to the sentinel lymph node biopsy and 9 to selective neck dissection. ![]() The present study aimed to evaluate the quality of life of patients with oral cavity squamous cell carcinoma T1/T2N0 submitted to sentinel lymph node biopsy compared to those that received selective neck dissection. However, the real effect of that method on the quality of life of such patients remains unknown. Sentinel lymph node biopsy is a proven method for staging the neck in patients with early oral cavity squamous cell carcinoma because it results in less comorbidity than the traditional method of selective neck dissection, with the same oncological results. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |