Radiotherapeutic management of bulky cervical lymphadenopathy in squamous cell carcinoma of the head and neck:Is Postradiotherapy Neck Dissection Necessary?

Johnson, Christopher R.; Silverman, Larry N.; Clay, Louise B.; Schmidt‐Ullrich, Rupert

doi:10.1002/(sici)1520-6823(1998)6:1<52::aid-roi6>3.0.co;2-h

Cited by 71 publications

(49 citation statements)

References 19 publications

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“…1,2 In the 1990s several centers demonstrated low rates of neck failure in patients who had a clinical complete response after RT. [3][4][5][6] These findings sparked interest in using the response to treatment to determine the need for a planned neck dissection after RT. At the University of Florida, computed tomography (CT) performed 4 weeks after completing RT was used to assess the nodal response in patients with cervical metastases.…”

Section: Resultsmentioning

confidence: 99%

Lymph node‐positive head and neck cancer treated with definitive radiotherapy

Yeung

Liauw

Amdur

et al. 2008

Cancer

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We investigated the prognostic impact of absolute lymphocyte count (ALC) following induction chemotherapy in newly diagnosed adult acute lymphoblastic leukemia (ALL). Patients with ALC ≥350 cells/μL at day 28 had a median overall survival (OS) of 47.4 months when compared with 17.6 months for those with an ALC <350 cells/μL (HR = 1.98, P = 0.007). Among patients who achieved a complete remission, median event‐free survival (EFS) for those with ALC ≥350 cells/μL on day 28 was 42.1 months when compared with 13.9 months in those with ALC <350 cells/μL (HR = 2.08, P = 0.006). In multivariable analysis, the ALC on day 28 (<350 cells/μL vs. ≥350 cells/μL, P ≤ .0004 for OS and EFS) along with WBC at diagnosis (≤6.0 or >30.0 K/μL vs. >6.0–30.0 K/μL, P ≤ 0.002 for OS and EFS) and cytogenetics (abnormal vs. normal, P = 0.002 for OS and P = 0.02 for EFS) were independent prognostic factors of both OS and EFS. Combining these three factors segregates patients in three well‐defined risk groups. These data suggest that ALC can be used in combination with other prognostic features to better predict outcome and that targeting the immune system to improve ALC may be a worthwhile strategy in ALL. Am. J.Hematol. © 2012 Wiley Periodicals, Inc.

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Section: Resultsmentioning

confidence: 99%

Lymph node‐positive head and neck cancer treated with definitive radiotherapy

Yeung

Liauw

Amdur

et al. 2008

Cancer

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“…In contrast to the results noted previously, other studies have shown that neck dissection may not influence regional control. 8,11 Koch et al 11 looked at 22 patients prospectively with advanced head and neck cancer of the oropharynx, oral cavity, and hypopharynx entered into a concurrent chemotherapy/radiotherapy protocol. All patients with N2 disease were scheduled for planned neck dissection of an unspecified type.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 In part because of this, the need for a postradiotherapy neck dissection in N2 clinical disease that has shown a clinical complete response after radiotherapy has been questioned. 8 However, residual disease in neck dissection specimens after organ preservation therapy has been shown in 34% to 50% of specimens. 5,7,9 At our institution, the treatment philosophy for patients with clinically positive neck disease greater than a small single unilateral metastatic lymph node has included a neck dissection at the conclusion of radiotherapy, whether chemotherapy has been used for primary organ preservation or not.…”

mentioning

confidence: 99%

Planned neck dissection for advanced primary head and neck malignancy treated with organ preservation therapy: Disease control and survival outcomes

et al. 2001

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“…1 It has been reported that any node-positive disease at diagnosis can lead to 5-year survival rates of less than 50%. 2 Brizel et al demonstrated a decreased rate of neck control by 35% in patients with N2 or greater regional disease who received CRT without ND as compared to ND patients.…”

Section: Neck Nodes Are Important Prognostic Factor Affecting Survivalmentioning

confidence: 99%

Salvage Neck Dissection after Chemoradiation in Head and Neck Cancer: Practice and Pitfalls

Agarwal¹,

Kundu²,

Krishnatry³

et al. 2012

International Journal of Head and Neck Surgery

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Locally advanced head and neck cancers are usually treated with concurrent chemoradiation. The residual nodes after chemoradiation in such patients are a common scenario, but the further investigation and treatment options in form of neck dissection are still not very clear. This review focuses on the current state of available evidence in literature for management of such patients and directs for the future development to fill the lacunae.

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Radiotherapeutic management of bulky cervical lymphadenopathy in squamous cell carcinoma of the head and neck:Is Postradiotherapy Neck Dissection Necessary?

Cited by 71 publications

References 19 publications

Lymph node‐positive head and neck cancer treated with definitive radiotherapy

Lymph node‐positive head and neck cancer treated with definitive radiotherapy

Planned neck dissection for advanced primary head and neck malignancy treated with organ preservation therapy: Disease control and survival outcomes

Salvage Neck Dissection after Chemoradiation in Head and Neck Cancer: Practice and Pitfalls

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