Updated systematic review on surgery for oral cancer

An operating theatre.

The existing Cochrane systematic review on surgical treatment of oral and oropharyngeal cancers has been updated, with important changes to the conclusions.

The reviewers concluded that  there was weak evidence to suggest that dissection of clinically negative neck nodes at the time of removal of the primary tumour reduced cancer recurrence.  However, there was insufficient evidence to conclude that elective neck dissection increases overall survival or disease free survival compared to therapeutic neck dissection.

Search strategy

The reviewers searched MEDLINE, EMBASE and the Cochrane Controlled Trials register and found seven randomised controlled trials, comprising 669 patients.  All of the trials were assessed as being of low quality.

Data extraction

The reviewers found data on the following comparisons:

  1. In patients with oral cavity cancer and clinically negative neck nodes, elective neck dissection compared with therapeutic neck dissection
  2. Elective radical neck dissection compared with elective selective neck dissection.
  3. Xurgery plus radiotherapy compared with radiotherapy alone.

Insufficient data was available to inform the latter two comparisons.   For the first comparison, significant clinical heterogeneity between the studies prevented any meta-analysis.


Bessell A, Glenny AM, Furness S, Clarkson JE, Oliver R, Conway DI, Macluskey M, Pavitt S, Sloan P, Worthington HV. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD006205. DOI: 10.1002/14651858.CD006205.pub3.

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Douglas Badenoch

I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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