Neck and shoulder morbidity in patients with oral cavity squamous cell carcinoma: a cross-sectional study

Abstract

Aim: In oral cavity squamous cell carcinomas (OCSCC) sentinel lymph node biopsy (SLNB) has emerged as an alternative or additional staging procedure. Although SLNB is still an invasive procedure and accompanied with fibrosis in the operated area, it is expected to gives less morbidity than elective neck dissection (END) by sparing relevant structures in the neck. Therefore, the aim of this study is to compare neck and shoulder morbidity and quality of life after END versus SLNB in patients T1/T2N0 OCSCC. Methods: We conducted a cross-sectional study of patients with T1/T2N0 who underwent END or SLNB between 20012 and 2019 at the University Medical Center Utrecht. We compared the neck and shoulder morbidity and health-related quality of life. Results: For the several questionnaires about neck (NDI: p=0.642 & NDII: p=0.831) and shoulder (SDQ: p=0.853 & SPADI p=0.450) disability as well for the quality of life (EORTC-QLQ-C30: p= 0.234 & EORTC-QLQ-H-N35 p=0.325) questionnaires we found no significant difference between END and SLNB. Only the contralateral lateroflexion for the neck showed a significant different (p=0.037) between END and SLNB in favor of the SLNB group. For the other physical examinations beside contralateral lateroflexion of the neck (flexion, extension, ipsilateral lateroflexion, ipsilateral rotation and contralateral rotation) and shoulder (anteflexion, abduction and exorotation) we found no significant difference END and the SLNB group. Conclusion: For neck morbidity, only the contralateral lateroflexion of the neck was significant better in favor of the SLNB group. There is no significant difference between shoulder morbidity and quality of life between END and the SLNB group. Clinical Relevance: The results of this study can provide insight into the neck and shoulder morbidity after END or SLNB and can be used as input to physiotherapy protocols related to management of the neck and shoulder.