Health-related quality of life in patients with T1N0 oral squamous cell carcinoma: selective neck dissection compared with wait and watch surveillance

McDonald, C, Lowe, D, Bekiroglu, F, Schache, A ORCID: 0000-0001-9466-6038, Shaw, R ORCID: 0000-0002-5157-4042 and Rogers, SN (2019) Health-related quality of life in patients with T1N0 oral squamous cell carcinoma: selective neck dissection compared with wait and watch surveillance. BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY, 57 (7). pp. 649-654.

Text
Stageone ND vs W&W reviwed 1.1.19.docx - Author Accepted Manuscript
Download (51kB)

Official URL: https://www.elsevier.com/en-gb

Abstract

Management of the neck in patients with clinical T1N0 oral squamous cell carcinoma (SCC) is controversial. The aim of this study was to report the health-related quality of life (HRQoL) in a consecutive group of patients with stage 1 disease at a time closest to two years after primary surgery. Of 216 patients treated between 2007 and 2012 (after excluding early death and regional recurrence), 195 were eligible. HRQoL was measured using the University of Washington quality of life questionnaire version 4. The overall response rate was 65% (126/195). HRQoL outcomes were good, but compared with patients in the wait and watch group, those who had selective neck dissection (SND) had more problems regarding appearance (14% compared with 1%, p = 0.008) and pain (19% compared with 6%, p = 0.04). Similar trends were seen for shoulder (14% compared with 8%), mood (16% compared with 8%), and speech (5% compared with 1%), and for poorer overall QoL (30% compared with 16%). It is difficult to establish why patients did or did not have neck dissection in a retrospective sample, but it is likely that those who had SND had larger tumours. The findings highlight the impact that SND has on HRQoL in domains such as appearance, pain, speech, swallowing, and chewing. Previous studies on SND have tended to focus on injury to the accessory nerve and shoulder function, but these new data emphasise the need to include other domains in future trials that compare wait and watch, SND, and sentinel lymph node biopsy.

Item Type:	Article
Uncontrolled Keywords:	Early oral cancer, neck dissection, health-related quality of life, squamous cell carcinoma, UW-QoLv4
Depositing User:	Symplectic Admin
Date Deposited:	12 Aug 2019 10:38
Last Modified:	19 Jan 2023 00:31
DOI:	10.1016/j.bjoms.2019.05.021
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3051500