Elective neck dissection during salvage surgery after radiotherapy in patients with head and neck squamous cell carcinoma.
Acta Otorhinolaryngol Ital
; 38(2): 86-93, 2018 Apr.
Article
in En
| MEDLINE
| ID: mdl-29967555
ABSTRACT
SUMMARY:
Elective neck dissection in patients with recurrent head and neck squamous cell carcinoma (HNSCC) without evidence of neck disease (crN0) is poorly defined. A retrospective review was carried out on 165 crN0 patients treated with salvage surgery and elective neck dissection. Multivariate Cox analysis and recursive partitioning analysis were used to evaluate prognostic factors. The frequency of occult neck node metastases in the neck dissection (rpN+) was 16.4%. The risk of occult metastases for glottic rpT1-T2 recurrences was 5.9%, for glottic rpT3-T4 recurrences 13.2%, for non-glottic rpT1-T2 recurrences 16.1% and for locally advanced (rpT3-T4) non-glottic recurrences 31.1%. Patients with occult neck node metastases (rpN+) had a 5-year adjusted survival rate of 38.1%, while patients without nodal disease (rpN0) had a 5-year adjusted survival rate of 71.1% (p = 0.0001). Elective neck dissection can be omitted in crN0 patients with rT1-T2 glottic recurrence. We consider it advisable to perform elective neck dissection in all other situations.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Neck Dissection
/
Salvage Therapy
/
Squamous Cell Carcinoma of Head and Neck
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Acta Otorhinolaryngol Ital
Year:
2018
Document type:
Article
Affiliation country:
España