BACKGROUND: Primary chemoradiation is a frequent treatment for locoregionally advanced head and neck squamous cell carcinoma. Some authors claim that a neck dissection (ND) is necessary in N2/N3 disease after this treatment in order to avoid regional recurrences. The aim of this study was to determine the incidence of isolated nodal failure in patients with N2/N3 disease who achieved a complete clinical and radiological response (CR) after chemoradiation, when no planned ND was performed. METHODS: We retrospectively analysed the survival rates, nodal response and subsequent neck nodal control of 28 patients with locally advanced oropharynx, hypopharynx or larynx squamous cell carcinoma disease, treated with primary chemoradiation. RESULTS: With a median follow-up of 28 months, 2-year global survival was 73% and disease-free survival 60%. Patients who had complete local and regional response after chemoradiotherapy were followed, with 100% neck nodal control. CONCLUSION: Patients with N2/N3 disease who obtained a clinical and radiological CR to chemoradiation had a zero incidence of isolated neck failure without a planned ND. The continued use of planned NDs in this patient subset may not be justified. This can be further confirmed in randomised prospective trials.
BACKGROUND: Primary chemoradiation is a frequent treatment for locoregionally advanced head and neck squamous cell carcinoma. Some authors claim that a neck dissection (ND) is necessary in N2/N3 disease after this treatment in order to avoid regional recurrences. The aim of this study was to determine the incidence of isolated nodal failure in patients with N2/N3 disease who achieved a complete clinical and radiological response (CR) after chemoradiation, when no planned ND was performed. METHODS: We retrospectively analysed the survival rates, nodal response and subsequent neck nodal control of 28 patients with locally advanced oropharynx, hypopharynx or larynx squamous cell carcinoma disease, treated with primary chemoradiation. RESULTS: With a median follow-up of 28 months, 2-year global survival was 73% and disease-free survival 60%. Patients who had complete local and regional response after chemoradiotherapy were followed, with 100% neck nodal control. CONCLUSION:Patients with N2/N3 disease who obtained a clinical and radiological CR to chemoradiation had a zero incidence of isolated neck failure without a planned ND. The continued use of planned NDs in this patient subset may not be justified. This can be further confirmed in randomised prospective trials.
Authors: Phillip K Pellitteri; Alfio Ferlito; Alessandra Rinaldo; Jatin P Shah; Randal S Weber; John Lowry; Jesus E Medina; Christine G Gourin; K Thomas Robbins; Carlos Suárez; Ashok R Shaha; Eric M Genden; C René Leemans; Jean Louis Lefebvre; Luiz P Kowalski; William I Wei Journal: Head Neck Date: 2006-02 Impact factor: 3.147
Authors: Anamaria R Yeung; Stanley L Liauw; Robert J Amdur; Anthony A Mancuso; Russell W Hinerman; Christopher G Morris; Douglas B Villaret; John W Werning; William M Mendenhall Journal: Cancer Date: 2008-03-01 Impact factor: 6.860
Authors: Laura A Goguen; Marshall R Posner; Roy B Tishler; Lori J Wirth; Charles M Norris; Donald J Annino; Christopher A Sullivan; Yi Li; Robert I Haddad Journal: Arch Otolaryngol Head Neck Surg Date: 2006-05
Authors: Gerhard G Grabenbauer; Claus Rödel; Antje Ernst-Stecken; Thomas Brunner; Joachim Hornung; Karsten Kittel; Helmut Steinhart; Heiner Iro; Rolf Sauer; Stefan Schultze-Mosgau Journal: Radiother Oncol Date: 2003-01 Impact factor: 6.280
Authors: Athanassios Argiris; Kerstin M Stenson; Bruce E Brockstein; Bharat B Mittal; Harold Pelzer; Merrill S Kies; Prathima Jayaram; Louis Portugal; Barry L Wenig; Fred R Rosen; Daniel J Haraf; Everett E Vokes Journal: Head Neck Date: 2004-05 Impact factor: 3.147
Authors: L Cerezo; A de la Torre; A Hervás; A Ruiz; O Liñán; M López; K Villar; M Martín Journal: Clin Transl Oncol Date: 2013-07-05 Impact factor: 3.405