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Evaluating contralateral neck failure in patients with lateralized OPSCC treated with transoral robotic surgery and neck management based on pre-operative SPECT-CT lymphatic mapping.
Berania, Ilyes; Hosni, Ali; Thomas, Carissa M; Goldstein, David; Bayley, Andrew; Mohan, Ravi; Hendler, Aaron; Cooper, Richard M; de Almeida, John R.
Afiliação
  • Berania I; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada.
  • Hosni A; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Thomas CM; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
  • Goldstein D; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada.
  • Bayley A; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Mohan R; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada.
  • Hendler A; Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Cooper RM; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
  • de Almeida JR; Department of Nuclear Medicine, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.
J Otolaryngol Head Neck Surg ; 51(1): 47, 2022 Dec 27.
Article em En | MEDLINE | ID: mdl-36575528
BACKGROUND: Risk of contralateral nodal metastases in oropharyngeal squamous cell carcinoma (OPSCC) is relatively low, however, many OPSCC patients receive bilateral neck treatment. This study evaluates the oncological outcomes with management of the contralateral cN0 neck based on lymphatic mapping with single photon emission computed tomography (SPECT-CT). METHODS: Retrospective evaluation of patients with lateralized cT1-2 and contralateral cN0 OPSCC treated with primary surgery between December 2017 and October 2019. All patients underwent pre-operative lymphatic mapping using SPECT-CT. Clinical parameters including demographics, tumor characteristics and oncological outcomes were recorded. RESULTS: Thirteen patients underwent primary site resection with transoral robotic surgery (TORS) and ipsilateral neck dissection with or without adjuvant therapy. Twelve patients (92.3%) had ipsilateral drainage on SPECT-CT, whereas 1 (7.7%) patient had bilateral neck lymphatic drainage. Four patients (30.8%) underwent post-operative radiation therapy (PORT). Three patients with unilateral drainage on SPECT-CT underwent PORT with unilateral neck irradiation, and 1 patient with bilateral drainage underwent PORT with bilateral neck irradiation. Seven (53.8%) patients were staged as pT1, 6 (46.2%) patients as pT2, 6 (46.2%) patients were pN0, 3 (23.1%) patients were pN1, 1 (7.7%) patient was pN2a for and 3 (23.1%) patients were N2b. The median distance of the tumor from midline was 1.05 cm (0.0-1.58). Primary sites included tonsil (n = 10, 76.9%) and tongue base (n = 3, 23.1%). The median follow-up time was 15.4 months. All patients were disease free at the latest follow-up with no contralateral neck failures. CONCLUSIONS: Pre-operative mapping of lymphatic drainage in early stage OPSCC with SPECT-CT is a promising tool which can reduce treatment to the contralateral neck potentially without compromising oncological outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Orofaríngeas / Procedimentos Cirúrgicos Robóticos / Neoplasias de Cabeça e Pescoço Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Otolaryngol Head Neck Surg Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Orofaríngeas / Procedimentos Cirúrgicos Robóticos / Neoplasias de Cabeça e Pescoço Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Otolaryngol Head Neck Surg Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Canadá