In-continuity neck dissection: long-term oncological outcomes in squamous cell carcinoma of the buccal mucosa

Publication date: Available online 11 November 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Li Xie, Yuanyuan Zhang, Wenxiao Huang, Jie Chen, Jianjun Yu, Xiao Zhou
PurposeTo introduce in-continuity neck dissection (ND) in squamous cell carcinoma of the buccal mucosa (BMSCC) and to determine its impact on the oncologic outcomes of these patients.MethodsA retrospective review of patients treated for BMSCC between 2006 and 2016 was performed. We adopted Kaplan-Meier analysis and log-rank test of local control (LC), regional control (RC), distant metastasis (DM) and disease specific survival (DSS) of in-continuity ND versus discontinuous ND in 220 previously untreated patients with BMSCC, followed by a multivariate Cox regression that included all significant variables.Results53 patients received discontinuous ND and 167 patients received in-continuity ND. Two groups were comparable. Univariate Kaplan-Meier analysis revealed that the 5-year DSS rates for discontinuous ND group and in-continuity ND group were 38 and 62% (P=0.023), respectively. The 5-year RC rate for in-continuity ND group (81%) was significantly better (P=0.004) than discontinuous ND group (54%). On Cox regression analysis, in-continuity ND significantly contributed to both higher RC rate and subsequently better DSS.ConclusionCompared with discontinuous ND, in-continuity ND predicted favorable oncological outcomes in BMSCC patients. We suggest in-continuity ND as a practical approach in the surgical management of BMSCC.



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