Behandling af patienter med orale planocellulaere karcinomer. De første erfaringer med nationale retningslinjer

INTRODUCTION: In 2003 the national guidelines for the treatment of patients with oral squamous cell carcinomas (OSCC) were established. Patients with clinically negative neck are now treated with surgery as opposed to radiotherapy previously. The aim of this study is to evaluate the surgical morbidity for these patients.

MATERIALS AND METHODS: This study included patients with primary diagnosed OSCC classified as T1-T2N0M0 treated between June 2003 and June 2005 at the Department of Otolaryngology--Head & Neck Surgery, Copenhagen University Hospital. The patients had their charts reviewed and 30 went to a clinical examination and were interviewed about complaints following the surgical treatment.

RESULTS: 60 patients were included. In order to be able to determine the complications of the surgical treatment, 30 of the 60 patients were excluded from the clinical examination. All patients attended and the median follow-up was 9 months. The transient complication most frequently registered was postoperative bleeding. The most frequent permanent complications were damage of the marginal branch (10%) and the sensory nerves, the major auricular nerve and the lingual nerve (13%). Patients undergoing bilateral neck dissection have an increased risk of complications.

CONCLUSION: The majority of complications were transient, and the patients had few complaints after the operation. The most frequently encountered complication was nerve damage, but the general morbidity was estimated to be reasonable. It is important that the guidelines are followed consistently and that the surgical skills are evaluated.