Adequacy of Surgery of Head and Neck Cancers

Abstract

Objective: To assess the proportion of adequate surgery in head and neck cancers. Study Design: Prospective longitudinal study. Place and Duration of Study: Medical Oncology Department, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jan to Dec 2020. Methodology: One fifty-nine patients aged over 20-65 years, of either gender with a confirmed diagnosis of squamous cell carcinoma of the Head and neck were included. Surgery was performed upfront in all patients without any preoperative/ induction chemotherapy. Data regarding socio-demographic and histopathology findings were noted. Surgery was labelled as inadequate when the number of resected lymph nodes recovered was less than 36, and the margins of the tumour were <5 mm (inadequate). Results: Of 159 patients, the average age was 46.57±9.73 years. Less than 36 lymph nodes were recovered in 84 patients (52.8%) after neck dissection. A total of 64 patients had inadequate margins (40.3%), 77 had adequate margins (48.4%), and 18 had positive margins (11.3%) on histopathological examination. Overall, 56 patients had adequate surgery (35.2%), and 103 had inadequate surgery (64.7%). Conclusion: More than half of the patients with Head and neck squamous cell carcinoma had inadequate surgery. Hence, inadequate surgery can lead to poor loco-regional disease control, increased chances of recurrence and overall poor prognosis.

Keywords

• Adequate surgery
• Adequate margins
• Carcinomas
• Head and neck cancers
• Perineural invasion