Elective neck dissection during salvage surgery after radiotherapy in patients with head and neck squamous cell carcinoma
Por:
Pedemonte, G, Esteller, E, Villator, JC, Costa, JM, Valero, C, Quer, M, Leon, X
Publicada:
1 abr 2018
Resumen:
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.
Filiaciones:
Pedemonte, G:
Hosp Mutua Terrassa, Otorhinolaryngol Dept, Barcelona, Spain
Esteller, E:
Univ Int Catalunya, Hosp Gen Catalunya, Otorhinolaryngol Dept, Barcelona, Spain
Villator, JC:
Univ Int Catalunya, Hosp Gen Catalunya, Otorhinolaryngol Dept, Barcelona, Spain
Costa, JM:
Hosp St Joan Despi Moises Broggi, Otorhinolaryngol Dept, Barcelona, Spain
Valero, C:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Otorhinolaryngol Dept, Barcelona, Spain
Quer, M:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Otorhinolaryngol Dept, Barcelona, Spain
Leon, X:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Otorhinolaryngol Dept, Barcelona, Spain
CIBER BBN, Madrid, Spain
Green Published, Hybrid Gold
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