BACKGROUND: For patients with head and neck cancer who were treated using primary radiotherapeutic approaches, the pattern of pathologic residual carcinoma in the neck dissection specimen and its effect on clinical outcome remains unknown. METHODS: Medical records of 65 patients who underwent 71 neck dissections a median 7 weeks after radiotherapy were reviewed. Median follow-up was 33 months. RESULTS: Residual cancer, identified in 28 patients (43%), diminished locoregional control (p = .018), recurrence-free (p = .018), and overall survival (p = .02). Thirteen patients (20%) had 2 or more pathologically involved lymph nodes. Nine (13%) involved level V. Four (6%) had pathologic involvement of nodal levels not clinically involved by cancer before treatment. In N2-3 patients with positive pathologic specimens, the presence of these factors diminished recurrence-free survival (p = .01). The outcome of patients with pathologic carcinoma but without such ominous factors approached those with negative pathology. CONCLUSIONS: For patients with residual carcinoma in the neck following radiation, the pattern of residual disease is an effective predictor of recurrence.
BACKGROUND: For patients with head and neck cancer who were treated using primary radiotherapeutic approaches, the pattern of pathologic residual carcinoma in the neck dissection specimen and its effect on clinical outcome remains unknown. METHODS: Medical records of 65 patients who underwent 71 neck dissections a median 7 weeks after radiotherapy were reviewed. Median follow-up was 33 months. RESULTS: Residual cancer, identified in 28 patients (43%), diminished locoregional control (p = .018), recurrence-free (p = .018), and overall survival (p = .02). Thirteen patients (20%) had 2 or more pathologically involved lymph nodes. Nine (13%) involved level V. Four (6%) had pathologic involvement of nodal levels not clinically involved by cancer before treatment. In N2-3 patients with positive pathologic specimens, the presence of these factors diminished recurrence-free survival (p = .01). The outcome of patients with pathologic carcinoma but without such ominous factors approached those with negative pathology. CONCLUSIONS: For patients with residual carcinoma in the neck following radiation, the pattern of residual disease is an effective predictor of recurrence.
Authors: Thomas J Galloway; Qiang Ed Zhang; Phuc Felix Nguyen-Tan; David I Rosenthal; Denis Soulieres; André Fortin; Craig L Silverman; Megan E Daly; John A Ridge; J Alexander Hammond; Quynh-Thu Le Journal: Int J Radiat Oncol Biol Phys Date: 2016-05-28 Impact factor: 7.038
Authors: Ian Ganly; Jennifer Bocker; Diane L Carlson; Salvatore D'Arpa; Maria Coleman; Nancy Lee; David G Pfister; Jatin P Shah; Snehal G Patel Journal: Head Neck Date: 2010-11-04 Impact factor: 3.147
Authors: R Maquieira; S K Haerle; G F Huber; A Soltermann; S R Haile; S J Stoeckli; Martina A Broglie Journal: Eur Arch Otorhinolaryngol Date: 2015-06-10 Impact factor: 2.503
Authors: L Putten; R Bree; P A Doornaert; J Buter; S E J Eerenstein; D H F Rietveld; D J Kuik; C R Leemans Journal: Acta Otorhinolaryngol Ital Date: 2015-06 Impact factor: 2.124