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Interventions for the treatment of oral and oropharyngeal cancers

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Interventions for the treatment of oral and oropharyngeal cancers : surgical treatment. / Bessell, Alyson (Lead / Corresponding author); Glenny, Anne-Marie; Furness, Susan; Clarkson, Jan E.; Oliver, Richard; Conway, David I.; Macluskey, Michaelina; Pavitt, Sue; Sloan, Philip; Worthington, Helen V.

In: Cochrane Database of Systematic Reviews, Vol. 2011, No. 9, CD006205, 2011, p. -.

Research output: Contribution to journalScientific review

Harvard

Bessell, A, Glenny, A-M, Furness, S, Clarkson, JE, Oliver, R, Conway, DI, Macluskey, M, Pavitt, S, Sloan, P & Worthington, HV 2011, 'Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment' Cochrane Database of Systematic Reviews, vol 2011, no. 9, CD006205, pp. -.

APA

Bessell, A., Glenny, A-M., Furness, S., Clarkson, J. E., Oliver, R., Conway, D. I., Macluskey, M., Pavitt, S., Sloan, P., & Worthington, H. V. (2011). Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database of Systematic Reviews, 2011(9), -[CD006205]doi: 10.1002/14651858.CD006205.pub3

Vancouver

Bessell A, Glenny A-M, Furness S, Clarkson JE, Oliver R, Conway DI et al. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database of Systematic Reviews. 2011;2011(9):-. CD006205.

Author

Bessell, Alyson (Lead / Corresponding author); Glenny, Anne-Marie; Furness, Susan; Clarkson, Jan E.; Oliver, Richard; Conway, David I.; Macluskey, Michaelina; Pavitt, Sue; Sloan, Philip; Worthington, Helen V. / Interventions for the treatment of oral and oropharyngeal cancers : surgical treatment.

In: Cochrane Database of Systematic Reviews, Vol. 2011, No. 9, CD006205, 2011, p. -.

Research output: Contribution to journalScientific review

Bibtex - Download

@article{6350318bc352416294efd621d3d643d3,
title = "Interventions for the treatment of oral and oropharyngeal cancers",
author = "Alyson Bessell and Anne-Marie Glenny and Susan Furness and Clarkson, {Jan E.} and Richard Oliver and Conway, {David I.} and Michaelina Macluskey and Sue Pavitt and Philip Sloan and Worthington, {Helen V.}",
year = "2011",
volume = "2011",
number = "9",
pages = "--",
journal = "Cochrane Database of Systematic Reviews",
issn = "1469-493X",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Interventions for the treatment of oral and oropharyngeal cancers

T2 - surgical treatment

A1 - Bessell,Alyson

A1 - Glenny,Anne-Marie

A1 - Furness,Susan

A1 - Clarkson,Jan E.

A1 - Oliver,Richard

A1 - Conway,David I.

A1 - Macluskey,Michaelina

A1 - Pavitt,Sue

A1 - Sloan,Philip

A1 - Worthington,Helen V.

AU - Bessell,Alyson

AU - Glenny,Anne-Marie

AU - Furness,Susan

AU - Clarkson,Jan E.

AU - Oliver,Richard

AU - Conway,David I.

AU - Macluskey,Michaelina

AU - Pavitt,Sue

AU - Sloan,Philip

AU - Worthington,Helen V.

PY - 2011

Y1 - 2011

N2 - <p>Background</p> <p>Surgery is an important part of the management of oral cavity cancer with regard to both the removal of the primary tumour and removal of lymph nodes in the neck. Surgery is less frequently used in oropharyngeal cancer. Surgery alone may be treatment for early stage disease or surgery may be used in combination with radiotherapy, chemotherapy and immunotherapy/biotherapy. There is variation in the recommended timing and extent of surgery in the overall treatment regimens of people with these cancers.</p> <p>Objectives</p> <p>To determine which surgical treatment modalities for oral cavity and oropharyngeal cancers result in increased overall survival, disease free survival, progression free survival and reduced recurrence.</p> <p>Search strategy</p> <p>The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 17 February 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID(1950 to 17 February 2011) and EMBASE via OVID (1980 to 17 February 2011). There were no restrictions regarding language or date of publication.</p> <p>Selection criteria</p> <p>Randomised controlled trials where more than 50% of participants had primary tumours of the oral cavity or oropharynx, and which compared two or more surgical treatment modalities or surgery versus other treatment modalities.</p> <p>Data collection and analysis</p> <p>Data extraction and assessment of risk of bias was undertaken independently by two or more review authors. Study authors were contacted for additional information as required. Adverse events data were collected from published trials.</p> <p>Main results</p> <p>Seven trials (n = 669; 667 with cancers of the oral cavity) satisfied the inclusion criteria, but none were assessed as low risk of bias. Trials were grouped into three main comparisons. Four trials compared elective neck dissection (ND) with therapeutic neck dissection in patients with oral cavity cancer and clinically negative neck nodes, but differences in type of surgery and duration of follow-up made meta-analysis inappropriate. Three of these trials reported overall and disease free survival. One trial showed a benefit for elective supraomohyoid neck dissection compared to therapeutic ND in overall and disease free survival. Two trials found no difference between elective radical ND and therapeutic ND for the outcomes of overall survival and disease free survival. All four trials found reduced locoregional recurrence following elective ND.</p> <p>A further two trials compared elective radical ND with elective selective ND and found no difference in overall survival, disease free survival or recurrence. The final trial compared surgery plus radiotherapy to radiotherapy alone but data were unreliable because the trial stopped early and there were multiple protocol violations.</p> <p>None of the trials reported quality of life as an outcome. Two trials, evaluating different comparisons reported adverse effects of treatment.</p> <p>Authors' conclusions</p> <p>Seven included trials evaluated neck dissection surgery in patients with oral cavity cancers. The review found weak evidence that elective neck dissection of clinically negative neck nodes at the time of removal of the primary tumour results in reduced locoregional recurrence, but there is insufficient evidence to conclude that elective neck dissection increases overall survival or disease free survival compared to therapeutic neck dissection. There is very weak evidence from one trial that elective supraomohyoid neck dissection may be associated with increased overall and disease free survival. There is no evidence that radical neck dissection increases overall survival compared to conservative neck dissection surgery. Reporting of adverse events in all trials was poor and it was not possible to compare the quality of life of patients undergoing different surgeries.<br/> <strong>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 9. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</strong></p>

AB - <p>Background</p> <p>Surgery is an important part of the management of oral cavity cancer with regard to both the removal of the primary tumour and removal of lymph nodes in the neck. Surgery is less frequently used in oropharyngeal cancer. Surgery alone may be treatment for early stage disease or surgery may be used in combination with radiotherapy, chemotherapy and immunotherapy/biotherapy. There is variation in the recommended timing and extent of surgery in the overall treatment regimens of people with these cancers.</p> <p>Objectives</p> <p>To determine which surgical treatment modalities for oral cavity and oropharyngeal cancers result in increased overall survival, disease free survival, progression free survival and reduced recurrence.</p> <p>Search strategy</p> <p>The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 17 February 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID(1950 to 17 February 2011) and EMBASE via OVID (1980 to 17 February 2011). There were no restrictions regarding language or date of publication.</p> <p>Selection criteria</p> <p>Randomised controlled trials where more than 50% of participants had primary tumours of the oral cavity or oropharynx, and which compared two or more surgical treatment modalities or surgery versus other treatment modalities.</p> <p>Data collection and analysis</p> <p>Data extraction and assessment of risk of bias was undertaken independently by two or more review authors. Study authors were contacted for additional information as required. Adverse events data were collected from published trials.</p> <p>Main results</p> <p>Seven trials (n = 669; 667 with cancers of the oral cavity) satisfied the inclusion criteria, but none were assessed as low risk of bias. Trials were grouped into three main comparisons. Four trials compared elective neck dissection (ND) with therapeutic neck dissection in patients with oral cavity cancer and clinically negative neck nodes, but differences in type of surgery and duration of follow-up made meta-analysis inappropriate. Three of these trials reported overall and disease free survival. One trial showed a benefit for elective supraomohyoid neck dissection compared to therapeutic ND in overall and disease free survival. Two trials found no difference between elective radical ND and therapeutic ND for the outcomes of overall survival and disease free survival. All four trials found reduced locoregional recurrence following elective ND.</p> <p>A further two trials compared elective radical ND with elective selective ND and found no difference in overall survival, disease free survival or recurrence. The final trial compared surgery plus radiotherapy to radiotherapy alone but data were unreliable because the trial stopped early and there were multiple protocol violations.</p> <p>None of the trials reported quality of life as an outcome. Two trials, evaluating different comparisons reported adverse effects of treatment.</p> <p>Authors' conclusions</p> <p>Seven included trials evaluated neck dissection surgery in patients with oral cavity cancers. The review found weak evidence that elective neck dissection of clinically negative neck nodes at the time of removal of the primary tumour results in reduced locoregional recurrence, but there is insufficient evidence to conclude that elective neck dissection increases overall survival or disease free survival compared to therapeutic neck dissection. There is very weak evidence from one trial that elective supraomohyoid neck dissection may be associated with increased overall and disease free survival. There is no evidence that radical neck dissection increases overall survival compared to conservative neck dissection surgery. Reporting of adverse events in all trials was poor and it was not possible to compare the quality of life of patients undergoing different surgeries.<br/> <strong>This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue 9. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</strong></p>

KW - Combined Modality Therapy [methods]

KW - Mouth Neoplasms [surgery]

KW - Oropharyngeal Neoplasms [surgery]

KW - Randomized Controlled Trials as Topic

KW - Humans

KW - SQUAMOUS-CELL CARCINOMA

KW - PROSPECTIVE RANDOMIZED-TRIAL

KW - PAPILLOMAVIRUS-ASSOCIATED CANCERS

KW - SUPRAOMOHYOID NECK DISSECTION

KW - SOUTHWEST-ONCOLOGY-GROUP

KW - ADVANCED RESECTABLE HEAD

KW - PREOPERATIVE IRRADIATION

KW - INDUCTION CHEMOTHERAPY

KW - PERILYMPHATIC INTERLEUKIN-2

KW - POSTOPERATIVE RADIOTHERAPY

U2 - 10.1002/14651858.CD006205.pub3

DO - 10.1002/14651858.CD006205.pub3

M1 - Scientific review

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

IS - 9

VL - 2011

SP - -

ER -

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