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.
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.
The reviewers found data on the following comparisons:
- In patients with oral cavity cancer and clinically negative neck nodes, elective neck dissection compared with therapeutic neck dissection
- Elective radical neck dissection compared with elective selective neck dissection.
- 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.