Discontinuous vs. in-continuity neck dissection in carcinoma of the oral cavity. Experience of two oncologic hospitals

Abstract

Many Authors have discussed the best indication and extension of neck dissection, but few have studied the surgical approach considering the continuity of neck dissection with the primary tumour. This retrospective study refers to patients submitted to major surgery between 1996 and 2001 for floor of mouth and oral tongue squamous cell carcinoma, at the Head and Neck Surgery Department of the Hospital "A.C. Camargo", São Paulo, Brazil and of the European Institute of Oncology, Milan, Italy. Patients were assigned to one of three groups: group I (in-continuity resection); group 2 (discontinuous resection) and group 3 (delayed discontinuous resection). Overall, 193 patients were studied. There were no differences in disease-free survival between the neck dissection groups. Furthermore, no statistical differences were found in disease specific survival between the groups. Discontinuous neck dissection seems not to change the disease-free survival or disease-specific survival when compared to in-continuity neck dissection, in this retrospective study. A prospective randomized trial is necessary to confirm these results.

Fig. 1

Disease-free survival curves for the three treatment groups in early stages: continuous (1); discontinuous simultaneous (2); discontinuous delayed (3).

Fig. 2

Disease-free survival curves for the two treatment groups in advanced stages: continuous (1); discontinuous simultaneous (2).

Fig. 3

Cancer-specific survival curves for the three treatment groups in early stages: continuous (1); discontinuous simultaneous (2); discontinuous delayed (3).

Fig. 4

Cancer-specific survival curves for the two treatment groups in advanced stages: continuous (1); discontinuous simultaneous (2).