Function, postoperative morbidity, and quality of life after cervical sentinel node biopsy and after selective neck dissection

Abstract

Background: Sentinel node biopsy (SNB) has been proposed for staging of N0 neck in oral/oropharyngeal carcinomas. It is claimed that SNB may be superior to selective neck dissection (SND) with respect to quality of life (QOL) and postoperative morbidity.

Methods: Twenty-four patients after SNB and 25 patients after SND (levels I-III) were enrolled. QOL and psychosocial variables were assessed by the health-related EORTC QLQ-C30 questionnaire, the disease-specific EORTC QLQ-H&N35 module, the Hospital Anxiety and Depression Scale, and a fear of progression questionnaire. The functional status was evaluated by scores for cervical scar, extent of lymphedema (Miller score), sensory function, function of facial and hypoglossal nerve, cervical spine, and shoulder (Constant score).

Results: Health-related QOL measurement revealed no differences between the 2 groups. Disease-specific QOL scores showed fewer swallowing problems in SNB patients (p = .043). SNB patients felt less fear of progression, experienced significantly less impairment from cervical scars, and had less sensory dysfunction and better shoulder function.

Conclusion: Functional outcome after SNB is significantly better than after SND; however, this is not reflected in the scores of QOL questionnaires.