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Early Surgery Improves Survival in Oral Cancer

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Patients with oral cancer that has not spread to lymph nodes achieve significantly improved survival if they elect to have surgery early in their treatment, compared to having surgery if their cancer recurs. These results were recently published in the New England Journal of Medicine.

Patients with oral cancer that has not spread to nearby lymph nodes have the option of undergoing surgery to remove lymph nodes in the neck upon initiation of treatment, or undergoing this surgery if cancer recurs in these lymph nodes.

Researchers recently conducted a clinical trial to evaluate the effects of the timing of surgery among patients with early oral cancer. The trial included nearly 600 patients, approximately half of whom were treated with surgery upon initiation of treatment, while the other half was treated with surgery if their cancer recurred.

At 3 years, overall survival was 80% for those undergoing early surgery, compared to 67.5% for those undergoing surgery upon recurrence.
Patients who underwent early surgery also had a higher rate of cancer-free survival at 3 years (69.5%) compared to those who underwent surgery upon relapse (45.9%).
The researchers concluded that among patients with early oral cancer, surgery to remove lymph nodes in the neck earlier in treatment results in improved overall and cancer-free survival compared to having the surgery at the time of recurrence.

Reference: D’Cruz A, Vaish R, Kapre N, et al. Elective versus therapeutic neck dissection in node-negative oral cancer. New England Journal of Medicine. 2015. 373:521-529. DOI: 10.1056/NEJMoa1506007