Neck Dissection's Burden on the Patient: Functional and Psychosocial Aspects in 1,652 Patients With Oral Squamous...

In this study of patients with oral squamous cell carcinoma, the authors sought to clarify the functional and psychosocial harms of neck dissection (ND), which lessens quality of life.

The study included questionnaire responses from patients with oral squamous cell carcinoma (n = 1,652) and clinicians (n = 1,489), as collected in the DÖSAK Rehab Study. Psychosocial and functional factors were assessed. Functional and psychosocial outcomes in patients who did not receive ND were compared with those in patients who underwent selective supraomohyoid ND (SND), modified radical ND (MND), and radical ND (RND).

Patients with ND had lower quality of life than those without ND. Burdens after SND (n = 923) were generally lesser than those after MND (n = 301) or RDN (n = 678). There were meaningful differences between the SND, MND, and RND and without-ND groups in impairments in speech intelligibility for strangers and familiar persons, ingestion and swallowing, tongue mobility, opening of the mouth, lower jaw mobility, neck mobility, and shoulder and arm movement (P < .05). Many patients with ND faced a lower functional status and negative professional and financial consequences.

Because of the burdens associated with ND, the decision to perform this treatment for oral squamous cell carcinoma should incorporate information on health-related quality of life and survival rates.