Oral SCC recurrence in the Neck
My dad was diagnosed with Oral SCC in dec 25. Tumor was on lateral side of the tongue , underwent surgery with clear margins. PT2N0, no LVI/PNI, DOI 4mm. END was done, 20 lymph nodes were removed, all tested negative. Doctors had not suggested Chemo/radiation back then.
2 weeks back, my dad felt a pea sized lump near his collarbone. Ultrasound/FNAC done, followed by PET CT confirmed SCC in multiple levels in neck, bilateral until level 6 (pre/para tracheal). 1.8 * 1.3 cm lump in left submandibular level. Doctors suggested a surgery but said it would be a major one with reconstruction (plastic surgery) due to lump being closer to the mouth. My dad does not want to go for the surgery
Doctor has given a few options -
Surgery followed by chemotherapy and radiation. Has said there is 50% chance of it not recurring again
chemotherapy and radiation. 30% of not recurring
chemotherapy followed by Surgery and then radiation.
The radio onco has also suggested surgery as the first option but my dad is just not ready for the surgery. He is just scared that quality of life will significantly decrease post surgery.
Just wanted to see what folks in similar situations have done and what was the outcome? Also, is surgery after chemo + radiation not recommended?