CHICAGO — Results from a randomized controlled phase 3 study presented here at the American Society of Clinical Oncology meeting show that preventive neck lymph node surgery resulted in a 37% reduction in risk for death compared with surgery after relapse.
Early surgery was associated with a significant 12.5% absolute increase in 3-year overall survival.
"Our study is the first to conclusively prove that more lives can be saved with elective neck dissection," lead investigator Anil D'Cruz, MBBS, from Tata Memorial Centre in Mumbai, India, said in a statement. "Armed with the results of this study, doctors will be able to confidently counsel patients that adding neck surgery to their initial treatment is worthwhile."
Preventive lymph node surgery resulted in a 56.0% reduction in the risk for relapse or death, with a 23.6% absolute increase in 3-year disease-free survival.
There were eight fewer deaths for every 15 fewer relapses with elective neck dissection, firmly establishing it as the standard of care in this disease, said Dr. D'Cruz.
The main disadvantage of neck dissection is that, because the nerve that supplies the large muscles involved in shoulder movement can be affected by the procedure, there can be some degree of shoulder dysfunction. Future research should focus on techniques to minimize this complication, the researchers say.
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Cite this: Preventive Surgery Saves Lives in Early Oral Cancer - Medscape - May 31, 2015.