Removing lymph nodules of oral cancer patients can improve survival: study

  • HT Correspondent, Hindustan Times, Mumbai
  • Updated: Jun 02, 2015 22:56 IST

Patients having early stages of oral cancer can be spared chemotherapy and radiation.

A 30-minute additional surgery to remove lymph nodules during primary surgery of patients during can reduce their risk of death by 36% and chances of recurrence of the malignancy by 55%.

This was found by doctors of Tata Memorial Hospital (TMH) during a clinical trial of 500 patients.

The findings are significant for the country which sees around 1 lakh new cases of oral cancer annually, a trend doctors attribute to the “tobacco consuming habit” of Indians.

Dr Anil K D’Cruz, who heads the head and neck cancer department of TMH, presented the findings of the study at the plenary session of American Society of Clinical Oncology on Sunday.

For more than 50 years, doctors have been debating the benefits of a prophylactic neck dissection versus therapeutic dissection of lymph nodes in the neck region, where oral cancer is most likely to spread.

Therapeutic dissection of lymph nodes refers to surgical removal of the lymph nodes in the advanced stage after the cancer spreads to the nodules from the oral cavity.

“Our study has proved that more lives can be saved with prophylactic neck dissection,” said Dr D’Cruz.

Doctors said a patient with early oral cancer undergoes surgery to remove the cancer lesions. While doing so, the surgeon can also operate to remove the lymph nodules in the neck region, irrespective of the evidence of malignancy. This, doctors said, is a prophylactic neck dissection which improves the overall survival rate by 12.5%.

“The additional surgery can lead to disfigurement and other complications as the area of operation has the facial nerve and other important arteries controlling functions,” said Dr Pankaj Chaturvedi, associate professor, head and neck cancer department at the hospital.

“The study, however has established the benefits as without adding any chemotherapy and radiation, there is reduction in recurrence of malignancy,” said Chaturvedi.

Researchers analysed the data of 500 patients randomly selected over 10 years (between 2004 and 2014). The participants were divided into two groups and offered prophylactic neck dissection and therapeutic dissection.

One death is prevented by performing prophylactic neck dissection in four patients. One recurrence is prevented for every four patients who undergo the additional surgery.

Tata Memorial Hospital, which is the apex institute for cancer treatment in India, will adopt prophylactic neck dissection as a standard of care in management of patients with early cancer.

* The use of tobacco, including smokeless tobacco, and excessive consumption of alcohol are the prominent risk factors for oral cancer.
* Oral cancer affects 3.4 lakh people worldwide.
* 90% of all oral cancer cases detected in India is because of alcohol and tobacco consumption.

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