Association of a multiple-step action with cervical lymph node yield of oral cancer patients in an Asian country

doi:10.1186/s12903-021-01389-3

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Title:	Association of a multiple-step action with cervical lymph node yield of oral cancer patients in an Asian country
Authors:	Yang, Ching-Chieh Kang, Bor-Hwang Liu, Wen-Shan Yin, Chun-Hao Lee, Ching-Chih
Contributors:	Chi Mei Med Ctr, Dept Radiat Oncol Chia Nan Univ Pharm & Sci, Dept Pharm Kaohsiung Vet Gen Hosp, Dept Otolaryngol Head & Neck Surg Natl Def Med Ctr, Sch Med Tajen Univ, Dept Pharm Kaohsiung Vet Gen Hosp, Dept Radiat Oncol Kaohsiung Vet Gen Hosp, Dept Med Educ & Res Natl Yang Ming Univ, Inst Hosp & Hlth Care Adm
Keywords:	Oral cancer Neck dissection Lymph node yield Quality Recurrence
Date:	2021
Issue Date:	2023-11-11 11:58:38 (UTC+8)
Publisher:	BMC
Abstract:	Background: High quality lymph node (LN) yield could increase survival, however strategies to improve LN yield have been seldom reported. This study aimed to assess the multiple-step action to promote quality of neck dissection in oral cancer. Methods: A total of 400 patients with oral cancer who underwent primary tumor resection and neck dissection, including elective and radical neck dissection, were recruited after propensity score matching by clinical T and N categories between January 2009 and September 2018. Patients were treated by two independent departments in our institute. A multiple-step action was initiated in October 2015 in one department, and another department was as a control group. The impact of multiple-step action on LN yield and regional recurrence were analyzed using multivariate analysis and difference-in-differences (DID) linear regression analysis. Results: The mean patient age was 55.2 + 11.1 years, and 92% were male. A total of 180 (45%) patients had T3-4 disease, and 129 (32%) patients had N2-3 disease. The multivariate linear regression and DID analyses revealed that multiple-step action had a positive effect on LN yield. A net improvement of LN yield with a coefficient of 13.78 (p < 0.001) after launching multiple-step action (since October 2015) was observed. A borderline protective effect of multiple-step action for cN0 patients with a reduced regional recurrence rate of 11.6% (p = 0.072) through DID analysis was noted. Conclusions: Multiple-step action was associated with increased LN yield and decreased regional recurrence in patients with oral cancer. The observed activity may promote surgeons to improve the quality of neck dissections, is feasible, and could be applied to a widespread patient population.
Relation:	BMC ORAL HEALTH, v.21, n.1, pp.29
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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