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Management of the clinically positive neck in organ preservation for advanced head and neck cancer
Management of the clinically positive neck in organ preservation for advanced head and neck cancer 44th Annual Meeting of the Society-of-Head-and-Neck-Surgeons Dagum, P., Pinto, H. A., Newman, J. P., Higgins, J. P., Terris, D. J., Goffinet, D. R., Fee, W. E. EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC. 1998: 448–52Abstract
To investigate clinicopathologic predictive criteria for the optimal management of neck metastases in patients with advanced head and neck cancers treated with combined chemoradiotherapy.Prospective study, 48 patients. Mean length follow-up, 23 months.Neck stage predicted neck response to chemoradiotherapy; N3 necks showed more partial responses (P = 0.04), and N1 necks showed more complete responses (P = 0.12). Primary tumor site strongly predicted the pathologic response found on neck dissection in patients with a clinical partial response (cPR) following chemoradiotherapy. There was no difference in survival between patients with a clinical complete response (cCR) after chemoradiotherapy, and patients with a pathologic complete response (pCR) after neck dissection (P = 0.20); however, when grouped together, these patients survived longer than did patients with a pPR at neck dissection (P = 0.06).Clinical response to induction chemotherapy is a poor predictor of ultimate neck control. Induction chemotherapy followed by chemoradiotherapy, and planned neck dissection for patients with persistent cervical lymphadenopathy, provides good regional control.
View details for Web of Science ID 000077441400013
View details for PubMedID 9874431