An audit of cT4a Head and Neck Cancer Treatment: A preliminary study from a Regional Head and Neck Unit

Abstract

Background: Head and neck cancer (HNC) is the sixth commonest cancer worldwide, with oral and pharyngeal squamous cell carcinoma types constituting about 75% of these HNC group.

Objective: To review the treatment of patients with cT4 HNC of the oral cavity, parotid gland, pharyngeal and laryngeal sites at a Regional Head and Neck Cancer Division.

Materials and Methods: The entry data book and medical records of cancer patients treated at the regional head and neck cancer division of the University Teaching Hospital (L-ASUTH), Lagos were reviewed for the study. Patients’ data collated included: biodata, clinical and histopathological data, treatment and outcome.  

Results: A total of 12 patients met the inclusion criteria for this study. Of these, six (50%) were females and six (50%) were males. Histopathological types were: seven (58.3%) squamous cell, three (25.0%) mucoepidermoid, one (8.3%) adenocarcinoma and one (8.3%) mesenchymal carcinoma patients had clinical nodal metastasis. Six patients had N₀ (50%), one had (14.3%) N₁, five out of seven patients who exhibited clinical evidence of nodal metastasis underwent neck dissections (NDs) were performed able major reconstructive surgeries were carried out inclusive of four pectoralis major myocutaneous (PMMC), two radial forearm free flaps (RFFF), one delto-pectoral flap (DPF) and one temporalis tendon transfer (TTT).

Conclusion: While the small sample size may not allow an inference conclusion from this study, surgery with adjuvant chemotherapy and radiotherapy improve the appropriate outcome of patients with cT4 HNC. Early presentation of patients and appropriate treatment modalities are important for good prognosis in these patients.