Oral and maxillofacial surgery
Long-term outcomes of endoscopic neck dissection in the treatment of early-stage oral cancer: a pilot study

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Objective

This study aimed to investigate the feasibility and safety of endoscopic neck dissection in the treatment of early-stage oral cancer and to evaluate the long-term clinical outcomes.

Study Design

Six patients with early-stage oral cancer were enrolled in this pilot study from December 2006 to May 2007. All the patients underwent endoscopic selective neck dissection (levels I-IV) of the ipsilateral neck and partial glossectomy or hemiglossectomy as the primary treatment.

Results

All endoscopic procedures were successfully performed, with important neck structures identified and preserved. All the patients survived with no persistent or recurrent disease during the 76- to 83-month follow-up.

Conclusions

Our preliminary results indicated that endoscopic neck dissection is a technically feasible and safe technique for treating early-stage oral cancer. The oncologic indications and validation should be further confirmed in patients with clinically positive neck lymph nodes in a future study.

Section snippets

Patients

Six patients with early-stage oral cavity SCC were enrolled prospectively in this pilot study in the Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-sen University, from December 2006 to May 2007. All the patients were pathologically confirmed as having SCC of the oral cavity by biopsy before the surgery. A medical history of all patients was taken, and a thorough physical examination and computed tomography scan of the head and neck were performed. The

Surgical results

In all 6 cases, endoscopic SND procedures (levels I-IV) were successfully performed. The median operating time of endoscopic SND was 152 minutes, ranging from 125 to 196 minutes. The average number of retrieved lymph nodes was 33 ± 3.9, and the median was 32, ranging from 28 to 40. All the lymph nodes were pathologically detected intact. There were no significant intraoperative complications and no conversion to conventional open surgery. Important neck anatomic landmarks and structures,

Discussion

In the present study, we firstly reported the long-term clinical outcome of endoscopic neck dissection (levels I-IV) for oral cancer. Our preliminary experience suggested that endoscopic neck dissection is a technically feasible, safe, and promising technique for treating early-stage oral cavity SCC.

On the premise of the multidisciplinary treatment, decreasing the extent of the surgical procedure, lowering the degree of postoperative disability, and improving quality of life become more and

Conclusion

Our preliminary experience suggested that endoscopic neck dissection is a technically feasible, safe, and promising technique for treating early-stage oral cavity SCC. The long operative time disadvantage may be overcome by experience accumulation and progress in instruments. However, the oncologic indications and validation should be confirmed in further large-scale comparative studies. Based on this study, we are now investigating the safety and efficacy of endoscopic neck dissection in

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    • This study was supported by Sun Yat-sen University 5010 Clinical Research Program (No. 2010018).

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