Finding the Adequacy of Surgery of Head and Neck Cancers in Pakistan
Bilal Younas, Waqas Ahmad Khalid, Mansoor Ul Hassan
Objective: To assess the proportion of adequate surgery in head and neck cancers. Study design: This Observational study was conducted in RHC Raiwind, District Lahore during June 2019 to June 2020 with the collaboration of Cancer Care center in Lahore. Methodology: One fifty nine patients of age more than 20-65 years of either sex with confirmed diagnosis of SCC of head and neck were included in the study. Surgery was done upfront in all patients without any preoperative/induction chemotherapy. Data regarding socio-demographic and histopathology findings were noted. Surgery was labelled as inadequate when number of resected lymph nodes recovered were less than 36 and margins of tumor were <5 mm (inadequate). Data was analyse using SPSS version 25. Results: Of 159 patients, average age was estimated as 46.57 ± 9.73 years. Less than 36 lymph nodes were recovered in 84 patients (52.8%) after neck dissection. A total of 64 patients had inadequate margins (40.3%), 77 had adequate margins (48.4%) and 18 had positive margins (11.3%) on histopathological examination. Overall, 56 patients had adequate surgery (35.2%) and 103 had inadequate surgery (64.7%). Conclusion: More than half of the patients with HNSCC had inadequate surgery. Hence, inadequate surgery can lead to poor loco-regional disease control, increased chances of recurrence and overall poor prognosis.