Quality of life after neck dissection: a multicenter longitudinal study by the Japanese Clinical Study Group on Standardization of Treatment for Lymph Node Metastasis of Head and Neck Cancer.

BACKGROUND

We performed a multicenter longitudinal study using our neck dissection questionnaire (NDQ) and arm abduction test (AAT) to assess the impact of rehabilitation and surgical modification on postoperative quality of life (QOL).

METHODS

Patients who had undergone neck dissection for the treatment of head and neck cancer answered the NDQ and completed the AAT 1, 3, 6, and 12 months after surgery. All patients enrolled in this study underwent a rehabilitation program designed for neck dissection. The obtained data were statistically analyzed according to the types of neck dissection and compared with the data of patients who had undergone neck dissection but not rehabilitation.

RESULTS

A total of 224 patients were enrolled in this study. Our findings revealed that resection of the sternocleidomastoid muscle (SCM) and spinal accessory nerve (SAN) resulted in shoulder drop. Lowering the dissection level and preservation of the SAN and SCM significantly reduced various sensory symptoms of the neck, such as stiffness, pain, numbness, and constriction, and improved shoulder function. Postoperative rehabilitation had a significant effect on arm abduction ability, particularly when the SCM and SAN were resected.

CONCLUSIONS

The study demonstrated that rehabilitation, in addition to modifications to radical neck dissection, contributed to the improvement of postoperative QOL after neck dissection.