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Long term survival in patients with human papillomavirus-positive oropharyngeal cancer and equivocal response on 12-week PET-CT is not compromised by the omission of neck dissection.
Zhou, Suyun; Chan, Christopher; Rulach, Robert; Dyab, Hesham; Hendry, Fraser; Maxfield, Carole; Dempsey, Mary-Frances; James, Allan; Grose, Derek; Lamb, Carolynn; Schipani, Stefano; Wilson, Christina; Cheng Lau, Yee; Paterson, Claire.
Afiliação
  • Zhou S; The Beatson West of Scotland Cancer Centre, Glasgow, UK.
  • Chan C; University Hospital Ayr, Ayr, UK.
  • Rulach R; University of Glasgow, Glasgow, UK.
  • Dyab H; West of Scotland PET Centre, Gartnavel General Hospital, Glasgow, UK.
  • Hendry F; West of Scotland PET Centre, Gartnavel General Hospital, Glasgow, UK.
  • Maxfield C; West of Scotland PET Centre, Gartnavel General Hospital, Glasgow, UK.
  • Dempsey MF; West of Scotland PET Centre, Gartnavel General Hospital, Glasgow, UK.
  • James A; The Beatson West of Scotland Cancer Centre, Glasgow, UK.
  • Grose D; The Beatson West of Scotland Cancer Centre, Glasgow, UK.
  • Lamb C; The Beatson West of Scotland Cancer Centre, Glasgow, UK.
  • Schipani S; The Beatson West of Scotland Cancer Centre, Glasgow, UK.
  • Wilson C; The Beatson West of Scotland Cancer Centre, Glasgow, UK.
  • Cheng Lau Y; Greater Glasgow and Clyde NHS Trust, Glasgow, UK.
  • Paterson C; The Beatson West of Scotland Cancer Centre, Glasgow, UK. Electronic address: Claire.Paterson2@ggc.scot.nhs.uk.
Oral Oncol ; 128: 105870, 2022 05.
Article em En | MEDLINE | ID: mdl-35447564
BACKGROUND AND AIM: The aim of this study was to evaluate the long-term safety of the omission of immediate neck dissections (IND) in patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC) achieving a less than complete nodal response on 12-week FDG PET-CT. MATERIAL AND METHODS: Patients with HPV-positive, node-positive HNSCC that were treated with radical (chemo) radiotherapy (RT) between January 2013 and September 2019 were identified. PET-CT responses were classified as complete (CR), incomplete (ICR) or equivocal (EQR) nodal responses. Clinical outcomes were obtained. RESULTS: 347 patients were identified. Median follow-up was 43.9 (IQR, 30.8-61.2) months. 62.8% (218/347) achieved a CR, 23.4% (81/347) EQR and 13.8% (48/347) ICR nodal response. 70 of 81 (86.4%) patients with an EQR and 25 of 48 (52.1%) with an ICR had no residual disease during follow up (a pathologically negative ND if surgery undertaken or no subsequent neck or distant relapse clinically/radiologically). Median survival of the EQR and CR groups were not reached, and despite the omission of IND in 95% of the EQR group there was no statistically significant differences in overall survival (OS) between the groups, p = 1.0. Median survival of ICR was not reached. However, OS for ICR group was significantly worse than that of CR, and EQR, both p < 0.001. CONCLUSION: The omission of IND in those achieving an EQR nodal response does not compromise long-term survival. This supports the safety of extended surveillance in patients with HPV-positive disease and an EQR on 12-week FDG PET-CT.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Infecções por Papillomavirus / Alphapapillomavirus / Neoplasias de Cabeça e Pescoço Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Oral Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Infecções por Papillomavirus / Alphapapillomavirus / Neoplasias de Cabeça e Pescoço Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Oral Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2022 Tipo de documento: Article