Retrospective audit of the recurrence rate amongst pathologically node negative (pN0) staged patients with oral...

Cases of oral squamous cell carcinoma (OSCC) are becoming more prevalent with an increasing population requiring surgical management. In cases where clinical staging indicates that there is no spread to the neck, surgical treatment options such as an elective neck dissection (END) may be considered. This audit aims to assess the recurrence rate in North London and Bristol Hospitals over a five-to-six-year period and to our knowledge is the first UK published study reporting isolated regional recurrence rate following END of OSCC. Regional MDT databases were used to identify patients given a pathological staging of pN0 following END in the same theatre session from 01.01.2017 to 01.01.2023 in London Northwest NHS Healthcare Trust and 01.01.2019 to 01.01.2024 in University Hospitals Bristol NHS Trust. Medical records were interrogated to retrospectively collect data on histopathology, staging, adjuvant treatments, recurrences, and follow up. A total of 232 patients were identified in total, with a minimum follow up of six months. The isolated regional recurrence rate was 2.2% with the locoregional recurrence rate being 3.9%. When categorising cases as pT1-T2 and pT3-4, the isolated regional recurrence rates were 3.3% and 0.9%, respectively. Overall, isolated neck recurrences were identified in five cases and locoregional recurrences were identified in nine. The findings of this audit show a lower recurrence rate in comparison to other international centres where similar studies have been performed. This supports the evidence that offering END in these trusts to patients with a pN0 staging continues to be an effective treatment option and should always be considered along with effective and consistent follow-up protocols and surveillance measures.