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. 2006 Dec;26(6):350-5.

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

M A S Tesseroli  1 , L Calabrese, A L Carvalho, L P Kowalski, F Chiesa
Affiliations

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

M A S Tesseroli et al. Acta Otorhinolaryngol Ital. 2006 Dec.

Abstract
in English, Italian

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.

Nei carcinomi della lingua e del pavimento orale l’indicazione ad una dissezione laterocervicale in blocco con la neoplasia primitiva ovvero differita è molto discussa, ed in letteratura esistono pochi contributi su questo argomento. Questo studio retrospettivo analizza i risultati di differenti atteggiamenti terapeutici sulle aree linfatiche laterocervicali in una serie di pazienti con carcinomi della lingua e del pavimento orale trattati dal 1996 al 2001 in due strutture oncologiche: l’Istituto “A. Camargo” di S. Paolo del Brasile e l’Istituto Europeo di Oncologa di Milano. I pazienti sono stati divisi in tre gruppi a seconda della tempistica dello svuotamento laterocervicale rispetto alla rimozione della neoplasia orale: 1) resezione in blocco della neoplasia con i linfonodi del collo; 2) linfoadenectomia laterocervicale sincrona ma non in continuità con la resezione della neoplasia primitiva; 3) linfoadenectomia laterocervicale differita di 30-40 giorni rispetto alla terapia della neoplasia primitiva.

Sono stati studiati globalmente 193 pazienti.

Non è stata evidenziata alcuna differenza statisticamente significativa fra i tre gruppi in termini di sopravvivenza da malattia. Sulla base di questo studio retrospettivo si può ipotizzare che le tre modalità terapeutiche di dissezione in blocco, sincrona discontinua e differita non modifichino la prognosi di pazienti con neoplasie della lingua e del pavimento orale. È necessario uno studio clinico prospettico randomizzato per confermare questa ipotesi.

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Figures

Fig. 1
Fig. 1
Disease-free survival curves for the three treatment groups in early stages: continuous (1); discontinuous simultaneous (2); discontinuous delayed (3).
Fig. 2
Fig. 2
Disease-free survival curves for the two treatment groups in advanced stages: continuous (1); discontinuous simultaneous (2).
Fig. 3
Fig. 3
Cancer-specific survival curves for the three treatment groups in early stages: continuous (1); discontinuous simultaneous (2); discontinuous delayed (3).
Fig. 4
Fig. 4
Cancer-specific survival curves for the two treatment groups in advanced stages: continuous (1); discontinuous simultaneous (2).
See this image and copyright information in PMC

References

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