Can early dental extractions reduce delays in post-operative radiation for patients with advanced oral cavity carcinoma?

Journal of Oral and Maxillofacial Surger.. - 3d ago Preview

 
 
• AUTO POST
 
• SAVE TO EVERNOTE

Publication date: Available online 25 May 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Madeleine P. Strohl, Jennifer Perkins Chen, Patrick K. Ha, Rahul Seth, Sue S. Yom, Chase M. Heaton

Abstract

Purpose

This study sought to evaluate the effect of early extractions on timing of post-operative radiation (PORT) for patients with advanced oral cavity squamous cell carcinoma (OCSCC).

Methods

All patients with OCSCC who required resection, free flap reconstruction and dental extractions in a 10-year period were retrospectively reviewed. The study included patients who preoperatively had advanced disease that indicated the need for adjuvant radiation as defined by advanced clinical T stage (T3 or T4a) or clinical nodal stage (N2a or above). Multivariate logistic regression models were created to estimate the risk factors for initiation of PORT greater than six weeks after surgery.

Results

Thirty-four patients were included. Thirteen patients underwent early extractions (on or before surgery). Twenty-one patients underwent extractions after surgery. Extractions included all teeth with periodontal disease within the expected field of radiation. The majority of patients underwent full mouth extractions (91.1%). 30.8% of patients in the early cohort initiated PORT > 6 weeks, while 72.4% in the late group experienced a delay (p=0.02). Early extractions were significantly associated with a decreased risk of PORT delay. There was no increase in operating room time for patients who underwent same-day extractions.

Conclusion

Early involvement of dental oncology and oral-maxillofacial surgeons can aid in the timely delivery of care for patients with advanced oral cavity cancer.