In order to gain any valuable information concerning prognostic data of a tumor entity, really good cooperation between many institutions is necessary. By performing standardized documentation and therapy, relevant data can be evaluated once the follow-up of the patients is complete.
A review is presented of the confusing terminology applied to the various types of neck dissection. It is recommended that the terms ''conservative'' and ''radical'' be based on clear definitions. The fourth prospective, randomized DOSAK therapy study deals with the controversial issue of radical as compared with conservative neck dissection. Patients with squamous cell carcinoma (SCC) of the oral cavity who had not been treated before were randomized and stratified according to the DOSAK treatment-dependent prognostic index (TPI). At present, 104 patients have been evaluated, of whom 48 had radical neck dissection, and 56 conservative neck dissection. Tumor location and patient age and sex are equally divided in both therapy groups. After an average follow-up time of 460 days, the relative mortality for both therapy groups is 23%. At this stage, there is no difference between the two groups in the percentage of patients with complete remission or in the percentage of patients alive. At this stage, there appears to be no difference between the two groups with regard to patient survival or recurrent disease.
The UICC plans to publish a modification of the TNM system. A proposal for a T category is calculated out of the data from the DOSAK tumour registry containing more than 3000 cases of primary squamous cell carcinomas of the oral cavity & oropharynx. By adding tumour thickness as a factor of the T component, the prognostic relevance of the classification is enhanced.
The computer-supported documentation of head and neck tumors by means of the BAIK-system is presented. The experience after introducing the project to clinical routine use in patient's treatment is outlined. The subsystems of BAIK are critically reviewed for this purpose. Although we realize some drawbacks of BAIK the system proved to be useful for our application, mainly because of its strong retrieval functions, combining coded and free text data manipulation.
