Effect of elective neck dissection versus sentinel lymph node biopsy on shoulder morbidity and health-related quality of life in patients with oral cavity cancer: A longitudinal comparative cohort study

Gerben van Hinte*, Tolunay Sancak, Willem L.J. Weijs, Matthias A.W. Merkx, Ruud A. Leijendekkers, Maria W.G. Nijhuis-van der Sanden, Robert Takes, Caroline M. Speksnijder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Objective: To research the difference in shoulder morbidity and health-related quality of life between patients with cT1-2N0 oral cavity squamous cell carcinoma that undergo either elective neck dissection (END) or a sentinel lymph node biopsy (SLNB) based approach of the neck. Materials and methods: A longitudinal study with measurements before surgery, 6 weeks, 6 months, and 12 months after surgery. Shoulder morbidity were determined with measurements of active range of motion of the shoulder and patient-reported outcomes for shoulder morbidity (SDQ, SPADI) and health-related quality of life (HR-QoL) (EQ5D, EORTC-QLQ-HN35). Linear mixed model analyses were used to analyze differences over time between patients that had END, SLNB or SLNB followed by complementing neck dissection. Results: We included 69 patients. Thirty-three patients were treated with END. Twenty-seven patients had SLNB without complementing neck dissection (SLNB), and nine were diagnosed lymph node positive followed by completion neck dissection (SLNB + ND). Ipsilateral shoulder abduction (P = .031) and forward flexion (P = .039) were significantly better for the SLNB group at 6 weeks post-intervention compared to the END and SLNB + ND group. No significant differences for shoulder morbidity, or health-related quality of life were found at 6 weeks, 6 months, and 12 months between the three groups. Conclusion: With oncologic equivalence for the END and SLNB as strategies for the cN0 neck already demonstrated, and the SLNB being more cost-effective, our demonstrated benefit in short-term shoulder function strengthens the choice for the SLNB as a preferred treatment strategy.

Original languageEnglish
Article number105510
Pages (from-to)1-7
JournalOral Oncology
Volume122
DOIs
Publication statusPublished - Nov 2021

Keywords

  • Morbidity
  • Mouth neoplasms
  • Neck dissection
  • Quality of life
  • Sentinel lymph node biopsy
  • Shoulder function
  • Humans
  • Lymphatic Metastasis
  • Shoulder/surgery
  • Mouth Neoplasms/pathology
  • Lymph Nodes/pathology
  • Quality of Life
  • Sentinel Lymph Node Biopsy
  • Neoplasm Staging
  • Longitudinal Studies
  • Neck Dissection

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