OBJECTIVE: To analyze the long-term results of patients with N3 neck metastasis from squamous carcinoma of the head and neck. STUDY DESIGN: This study is based on the analysis of a retrospective cohort of 224 previously untreated patients with squamous cell carcinoma of the head and neck and lymph node metastasis sized greater than 6 cm (N3) who were evaluated from 1981 to 1996. RESULTS: Fifty-four patients (24.1%) underwent neck dissection, 137 underwent radiotherapy alone (61.2%), and 33 received only supportive care (14.7%). Control of the neck metastasis was achieved in 46 cases among the treated ones (24.1%), varying from 51.9% for the patients who underwent surgery to 13.1% for radiotherapy alone ( P < 0.001). Exclusive distant metastasis occurred in 37.0% of the cases who had control of the neck disease. The 3-year overall survival rates were 17.9% for patients who underwent surgery and 7.0% for radiotherapy alone ( P = 0.003). The multivariate analysis showed as independent predictive factors the treatment approach ( P < 0.001) and tumor site ( P = 0.016). CONCLUSIONS: This study confirms the poor prognosis of patients with N3 neck disease, mainly when treated by radiotherapy alone. A radical neck dissection associated with adjuvant radiotherapy is indicated whenever feasible. Because of the high rate of distant metastasis, protocols including adjuvant chemotherapy should be investigated.
OBJECTIVE: To analyze the long-term results of patients with N3 neck metastasis from squamous carcinoma of the head and neck. STUDY DESIGN: This study is based on the analysis of a retrospective cohort of 224 previously untreated patients with squamous cell carcinoma of the head and neck and lymph node metastasis sized greater than 6 cm (N3) who were evaluated from 1981 to 1996. RESULTS: Fifty-four patients (24.1%) underwent neck dissection, 137 underwent radiotherapy alone (61.2%), and 33 received only supportive care (14.7%). Control of the neck metastasis was achieved in 46 cases among the treated ones (24.1%), varying from 51.9% for the patients who underwent surgery to 13.1% for radiotherapy alone ( P < 0.001). Exclusive distant metastasis occurred in 37.0% of the cases who had control of the neck disease. The 3-year overall survival rates were 17.9% for patients who underwent surgery and 7.0% for radiotherapy alone ( P = 0.003). The multivariate analysis showed as independent predictive factors the treatment approach ( P < 0.001) and tumor site ( P = 0.016). CONCLUSIONS: This study confirms the poor prognosis of patients with N3 neck disease, mainly when treated by radiotherapy alone. A radical neck dissection associated with adjuvant radiotherapy is indicated whenever feasible. Because of the high rate of distant metastasis, protocols including adjuvant chemotherapy should be investigated.
Authors: James A Keir; Olivia J H Whiteside; Stuart C Winter; Sushir Maitra; Rogan C Corbridge; Graham J Cox Journal: Ann R Coll Surg Engl Date: 2007-10 Impact factor: 1.891
Authors: Matthew Lam; Abhijit J Chaudhari; Yang Sun; Feifei Zhou; Allison Dobbie; Regina F Gandour-Edwards; Steve P Tinling; D Gregory Farwell; Wayne L Monsky; K Kirk Shung; Laura Marcu Journal: J Ultrasound Med Date: 2013-10 Impact factor: 2.153
Authors: Sabrina Daniela da Silva; Michael Hier; Alex Mlynarek; Luiz Paulo Kowalski; Moulay A Alaoui-Jamali Journal: Front Pharmacol Date: 2012-07-30 Impact factor: 5.810