Surgical complications and quality of life according to the extent of neck dissection in patients treated for oral squamous cell carcinoma

被引：0

作者：

Mrosk, Friedrich ^{[1
,2
,3
]}

Issa, Haura ^{[1
,2
,3
]}

Hildebrandt, Tim ^{[4
]}

Moedl, Lukas ^{[2
,3
,5
]}

Doll, Christian ^{[1
,2
,3
]}

Kreutzer, Kilian ^{[1
,2
,3
]}

Rendenbach, Carsten ^{[1
,2
,3
]}

Voss, Jan Oliver ^{[1
,2
,3
,6
]}

Heiland, Max ^{[1
,2
,3
]}

Koerdt, Steffen ^{[1
,2
,3
]}

机构：

[1] Charite Univ Med Berlin, Dept Oral & Maxillofacial Surg, Augustenburger Pl 1, D-13353 Berlin, Germany

[2] Free Univ Berlin, Augustenburger Pl 1, D-13353 Berlin, Germany

[3] Humboldt Univ, Augustenburger Pl 1, D-13353 Berlin, Germany

[4] Ludwig Maximilians Univ Munchen, Dept Oral & Maxillofacial Surg, Lindwurmstr 2A, D-80337 Munich, Germany

[5] Charite Univ Med Berlin, Inst Biometry & Clin Epidemiol, Charitepl 1, D-10117 Berlin, Germany

[6] Charite Univ Med Berlin, Berlin Inst Hlth, Charitepl 1, D-10117 Berlin, Germany

来源：

CLINICAL ORAL INVESTIGATIONS | 2025年 / 29卷 / 03期

关键词：

Oral squamous cell carcinoma; Quality of life; Surgical complications; Neck dissection; Extent; CANCER; HEAD; MANAGEMENT;

D O I：

10.1007/s00784-025-06247-y

中图分类号：

R78 [口腔科学];

学科分类号：

1003 ;

摘要：

ObjectiveQuality of life (QoL) and the degree of postoperative morbidity is an important aspect for patients suffering from oral squamous cell carcinoma (OSCC), which can be affected by several aspects of cancer treatment and especially the extent of surgical therapy. The aim of this study was to evaluate the clinical outcome and QoL in patients in relation to different types of neck dissection (ND) for OSCC.Materials and methodsIn this observational single center cohort study, OSCC patients who underwent primary resection and ND between 2017 and 2022 were included and assessed for postoperative complications. Furthermore, a subcohort of patients who presented in regular tumor aftercare was prospectively examined regarding QoL and shoulder functioning, using a modified version of the EORTC quality of life core questionnaire with its head and neck cancer module (EORTC-QLQ-H&N43). Differences in QoL between patients were analyzed regarding the extent of ND (selective vs. modified radical ND; ipsilateral vs. bilateral ND), adjuvant therapy and presence of postoperative complications.ResultsOverall, 350 patients with a mean age of 66 years (+/- 11.6) were enrolled in the study. The overall complication rate was 12.6%, while extended ND procedures (modified radical ND and bilateral ND) were associated with higher complications. A subcohort of 57 patients participated in QoL assessment. There were clinically relevant differences (20 points and more in QoL) in relation to the extent of ND in the following domains: impaired swallowing of solid food, mouth opening limitation, sticky saliva, impaired smelling, impaired eating ability, impaired speech, shoulder pain and stiffness in the neck and shoulder area, while selected objects were influenced by adjuvant therapy. While patients with extended neck treatment presented with significantly more shoulder pain, there were no significant differences in shoulder functioning among the different ND modalities.ConclusionsThe results of this study provide an insight into QoL issues in relation to OSCC and may help to consult patients who are confronted at the beginning of the disease as well as by approaching selected health issues by specific functional treatment during follow-up.Clinical relevanceIn this study, it could be shown that extensive surgical neck treatment is associated with higher complication rates and lower quality of life, highlighting the relevance of surgical de-escalation if feasible.

引用

页数：9

共 32 条

[1]

Lo W.L., Kao S.Y., Chi L.Y., Et al., Outcomes of oral squamous cell carcinoma in Taiwan after surgical therapy: factors affecting survival, J Oral Maxillofac Surg, 61, pp. 751-758, (2003)

[2]

Head and Neck Cancers (Version, 1, (2023)

[3]

Koerdt S., Rockl J., Rommel N., Et al., Lymph node management in the treatment of oral cancer: analysis of a standardized approach, J Cranio-Maxillofacial Surg, 44, pp. 1737-1742, (2016)

[4]

Doll C., Steffen C., Amthauer H., Et al., Sentinel lymph node biopsy in early stages of oral squamous cell carcinoma using the receptor-targeted Radiotracer 99mTc-tilmanocept, Diagnostics, 11, pp. 1-10, (2021)

[5]

Chan J.Y.K., Wong E.W., Ng S.K., Et al., Conservative management of postoperative chylous fistula with octreotide and peripheral total parenteral nutrition, Ear Nose Throat J, 96, pp. 264-267, (2017)

[6]

Cannady S.B., Hatten K.M., Bur A.M., Et al., Use of free tissue transfer in head and neck cancer surgery and risk of overall and serious complication(s): an American college of Surgeons-National surgical quality improvement project analysis of free tissue transfer to the head and neck, Head Neck, 39, pp. 702-707, (2017)

[7]

Mrosk F., Doll C., Scheer J., Et al., Oncologic outcome in advanced oral squamous cell carcinoma after refusal of recommended adjuvant therapy, JAMA Otolaryngol Head Neck Surg, 149, pp. 1027-1033, (2023)

[8]

Frohwitter G., Rockl J., Rau A., Et al., Evaluation of neck dissection with frozen section biopsy– Management of levels IV and V, J Cranio-Maxillofacial Surg, 47, pp. 1963-1967, (2019)

[9]

Dunlap Q., Gardner J.R., Ederle A., Et al., Comparative morbidity profile of elective vs therapeutic neck dissection, Otolaryngol - Head Neck Surg (United States), 166, pp. 327-333, (2022)

[10]

So W.K.W., Chan R.J., Chan D.N.S., Et al., Quality-of-life among head and neck cancer survivors at one year after treatment - A systematic review, Eur J Cancer, 48, pp. 2391-2408, (2012)

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