Can early dental extractions reduce delays in post-operative radiation for patients with advanced oral cavity carcinoma?
Madeleine P. Strohl, MD1,∗,'Correspondence information about the author MD Madeleine P. StrohlEmail the author MD Madeleine P. Strohl, Jennifer Perkins Chen, DDS, MD2, Patrick K. Ha, MD1, Rahul Seth, MD1, Sue S. Yom, MD, PhD3, Chase M. Heaton, MD1
DOI: https://doi.org/10.1016/j.joms.2019.05.007
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Publication History
Published online: May 24, 2019
Accepted: May 6, 2019
Received in revised form: May 1, 2019
Received: April 16, 2019
Abstract
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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.
Key words:
oral cavity squamous cell carcinoma, adjuvant radiation, dental extractions
Madeleine P. Strohl, MD1,∗,'Correspondence information about the author MD Madeleine P. StrohlEmail the author MD Madeleine P. Strohl, Jennifer Perkins Chen, DDS, MD2, Patrick K. Ha, MD1, Rahul Seth, MD1, Sue S. Yom, MD, PhD3, Chase M. Heaton, MD1
DOI: https://doi.org/10.1016/j.joms.2019.05.007
hideArticle Info
Publication History
Published online: May 24, 2019
Accepted: May 6, 2019
Received in revised form: May 1, 2019
Received: April 16, 2019
Abstract
Full Text
Images
References
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.
Key words:
oral cavity squamous cell carcinoma, adjuvant radiation, dental extractions
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