A new study from researchers at New York University in New York City found that oral cancer pain level at the primary site may help physicians identify which patients with occult metastases will benefit from neck dissection.
The investigators, led by senior author Donna Albertson, MD, presented their results in a poster on September 13 at the International Association for the Study of Pain (IASP) World Congress on Pain in Boston.
The researchers enrolled 72 patients undergoing curative surgery for oral cancer, with or without neck dissection, and asked them to rate their pain using the University of California San Francisco Oral Cancer Pain Questionnaire (PQ). The questionnaire asks patients to rate the intensity of their pain on a 0–100 point visual analogue scale in response to eight questions, which differentiated spontaneous and function-related pain and determine the quality of pain. The questions also asked about sharpness and aching, sensitivity to touch, details about pain when talking, eating or drinking, and interference with function.
Researchers collected preoperative cervical nodal status from physical examination notes and radiology reports, and postoperative cervical nodal status from pathology reports. Inclusion criteria included diagnosis of an oral squamous cell carcinoma, planned curative resection, and completion of the PQ within six weeks of surgery. Exclusion criteria included prior chemo- or radiation therapy for cancer, failure to complete or understand the questionnaire, and less than one year post-surgery follow up. A total of 66 patients (35 node negative and 31 node positive) met the inclusion criteria, and higher pain scores were reported by patients with node-positive cancers, as opposed to node-negative.
The researchers concluded their results showed that pain assessed prior to surgery could identify patients with occult metastases who would benefit from neck dissection.