Adjuvant Low Single Dose Cisplatin-based Concurrent Radiochemotherapy of Oral Cavity and Oropharynx Carcinoma

Kuhnt, Thomas; Klockenbrink, Ulf; Knipping, S.; Lautermann, J.; Kriese, Karen; Wienke, Andreas; Hildebrandt, Guido; Hauptmann, Steffen

doi:10.1007/s00066-011-2186-x

Cited by 13 publications

(5 citation statements)

References 22 publications

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“…1 ECS is correlated with increased rates of recurrence, contralateral recurrence, occurrence in unusual sites, and distant metastasis. 2–6 ECS is identified in up to 50% of neck dissection specimens and in approximately 20% of patients with HNSCC who have clinically negative neck examinations. 7 The current standard for the identification of ECS in patients with HNSCC is histopathological examination of neck dissection specimens.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes

et al. 2017

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Background and purpose In patients with squamous cell carcinoma of the head and neck (HNSCC), extracapsular spread (ECS) of metastases in cervical lymph nodes affects prognosis and therapy. We assessed the accuracy of intravenous contrast-enhanced computed tomography (CT) and the utility of imaging criteria for preoperative detection of ECS in metastatic cervical lymph nodes in patients with HNSCC. Materials and methods Preoperative intravenous contrast-enhanced neck CT images of 93 patients with histopathological HNSCC metastatic nodes were retrospectively assessed by two neuroradiologists for ECS status and ECS imaging criteria. Radiological assessments were compared with histopathological assessments of neck dissection specimens, and interobserver agreement of ECS status and ECS imaging criteria were measured. Results Sensitivity, specificity, positive predictive value, and accuracy for overall ECS assessment were 57%, 81%, 82% and 67% for observer 1, and 66%, 76%, 80% and 70% for observer 2, respectively. Correlating three or more ECS imaging criteria with histopathological ECS increased specificity and positive predictive value, but decreased sensitivity and accuracy. Interobserver agreement for overall ECS assessment demonstrated a kappa of 0.59. Central necrosis had the highest kappa of 0.74. Conclusion CT has moderate specificity for ECS assessment in HNSCC metastatic cervical nodes. Identifying three or more ECS imaging criteria raises specificity and positive predictive value, therefore preoperative identification of multiple criteria may be clinically useful. Interobserver agreement is moderate for overall ECS assessment, substantial for central necrosis. Other ECS CT criteria had moderate agreement at best and therefore should not be used individually as criteria for detecting ECS by CT.

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Section: Introductionmentioning

confidence: 99%

Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes

et al. 2017

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“…Cervical lymph node metastasis is the single most important prognostic factor for pa-tients with oral cavity SCC, and accurately evaluating cervical lymph node metastases is critical for surgical and adjuvant therapy planning. Additionally, ENE-defined as extension of the metastatic tumor through the lymph node capsule into the surrounding connective tissue-is a known independent risk factor for the development of recurrence and distant metastases [16][17][18]. Wreesmann et al [3] and Myers et al [19] reported that patients with tongue cancer and ENE showed poor survival outcomes, with higher rates of regional recurrence and distant metastases than patients with positive cervical lymph nodes without ENE.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Cervical Nodal Necrosis Observed in Preoperative CT and MRI of Patients With Tongue Squamous Cell Carcinoma and Cervical Node Metastases: A Retrospective Study

Baik

Seo

Kim

et al. 2019

American Journal of Roentgenology

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recent technical advances in surgical management and radiation therapy, some patients inevitably experience locoregional recurrence or distant metastases within 2 years after treatment completion [6]. Because the importance of precision medicine or individually tailored treatment has been emphasized in cancer treatment, imaging biomarkers that stratify patients at risk for treatment failure (TF) would be useful for identifying patients who could be candidates for additional treatment or deescalation treatment.Cervical nodal necrosis (CNN) is an important imaging feature used to distinguish between benign and malignant lymph nodes. Recent studies have reported that CNN, as an imaging biomarker, could be an important negative prognostic factor for patients with various head and neck cancers [7][8][9][10]. However, to our knowledge, the prognostic value of CNN observed on preoperative imaging

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“…ECS is associated with decreased 5‐year disease‐specific survival to approximately 40%, compared to 70% among those without ECS . Moreover, ECS is an independent risk factor for the development of contralateral recurrence, recurrence in an unusual location, and distant metastases . Finally, a comparative analysis of patients with advanced‐stage head and neck cancers demonstrated that those patients with ECS were most likely to benefit from the addition of chemotherapy to adjuvant radiation …”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma

et al. 2014

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Adjuvant Low Single Dose Cisplatin-based Concurrent Radiochemotherapy of Oral Cavity and Oropharynx Carcinoma

Abstract: Patients with ECS have an increased risk of distant metastases. Adjuvant low single dose cisplatin-based concurrent chemotherapy seems to have no influence on occult microscopic systemic disease.

Cited by 13 publications

References 22 publications

Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes

Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes

Prognostic Value of Cervical Nodal Necrosis Observed in Preoperative CT and MRI of Patients With Tongue Squamous Cell Carcinoma and Cervical Node Metastases: A Retrospective Study

Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma

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