Neck Dissection in Patients with Oral Squamous Cell Carcinoma in Dharmais Hospital, Jakarta

Oral squamous cell carcinoma (OSCC) is one of the rarest cancers worldwide. In Indonesia, the incidence is less than five thousands per year, and the mortality rate is almost 50%. More than 50% patients with OSCC have lymph node metastasis; the proportion of occult metastasis is 24-42%. Those with lymph node metastatis have the worst possibility of survival. This study aimed to estimate the survival of OSCC patients with neck dissections. We conducted a retrospective cohort study of 78 patients with OSCC who were treated in Dharmais National Cancer Hospital between 1 January 2003 and 31 January 2013. The three years survival rate post diagnosis, post neck dissection was calculated using Kaplan —Meier survival curves and statistically tested using a log-rank test. Cox proportional hazard models were applied to assess the prognostic significance of neck dissections. Of the total patients in this study (n=78), 53.8% of patients had surgery. Of patients who underwent surgery, 71.4% had a neck dissection surgery. These patients were in either early or advanced stages of cancer. Overall survival showed that patients who received neck dissections had better survival rates (58.2%) than patients who did not receive neck dissection (32.2%). Stratification at every stage of cancer (I, II, III, and IV) showed better survival in patients with neck dissections. The risk of patients without neck dissections is higher than patient with neck dissection to die, Hazard Ration(HR)=2.19 (CI95% 1.04-4.62, p=0.028). Adequate neck dissection surgery increases chances of survival in patients with OSCC.