Selective neck dissection for neck residue of nasopharyngeal carcinoma: A prospective study

Chen, J.Y.; Zhang, L.; Ji, Qing; Li, D.S.; Shen, Qingyu; Wang, Z.Y.; Huang, Chenlu; Wang, Y.; Zhu, Yong

doi:10.1016/j.jcms.2015.06.037

Cited by 11 publications

(13 citation statements)

References 22 publications

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“…Compared with MRND, RND, and END, trauma, hemorrhage, and operation time were reduced in SND. With SND, the patients' quality of life is also higher; some studies have even shown that SND may result in excellent regional control on the basis of a select group of patients with cervical nodal metastases . SND was recommended for the salvage treatment of neck residue NPC because it was found to be comparable to CND in terms of survival .…”

Section: Discussionmentioning

confidence: 99%

“…With SND, the patients' quality of life is also higher; some studies have even shown that SND may result in excellent regional control on the basis of a select group of patients with cervical nodal metastases. [31][32][33][34] SND was recommended for the salvage treatment of neck residue NPC because it was found to be comparable to CND in terms of survival. 27,34 However, whether SND could replace CND in regional failure NPC requires more investigation.…”

Section: Discussionmentioning

confidence: 99%

“…[31][32][33][34] SND was recommended for the salvage treatment of neck residue NPC because it was found to be comparable to CND in terms of survival. 27,34 However, whether SND could replace CND in regional failure NPC requires more investigation. Newly diagnosed NPC is usually accompanied with metastatic cervical lymph nodes, and the involvement for level I to level V in node-positive cases is 3.0%, 97.9%, 46.0%, 9.5%, and 13.7%.…”

Section: Discussionmentioning

confidence: 99%

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Surgery for isolated regional failure in nasopharyngeal carcinoma after radiation: Selective or comprehensive neck dissection

Liu

You

et al. 2018

The Laryngoscope

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Objective To compare survival effects of comprehensive neck dissection (CND) and selective neck dissection (SND) for patients with nasopharyngeal carcinoma (NPC) with only regional failure. Methods A total of 294 recurrent T0N1‐3M0 NPC patients who underwent neck dissection in Sun Yat‐Sen University Cancer Center, Guangzhou, People's Republic of China, between January 1984 and February 2014, were enrolled in the survival and interaction analyses. Using propensity scores to adjust for potential prognostic factors, an additional well‐balanced cohort of 210 patients was constructed by matching each patient who received SND with one patient who underwent CND (1:1); the differences were then compared between SND and CND in terms of overall survival (OS), local recurrence‐free survival (LRFS), regional recurrence‐free survival (RRFS), and distant metastasis‐free survival (DMFS). Results Both univariate and multivariate analyses showed that SND was not inferior to CND (P > 0.05) but demonstrated that extracapsular spread (ECS) (hazard ratio [HR] 3.49, 95% confidence interval [CI] 2.30–5.29, P < 0.001), recurrent N stage (rN stage) (HR 1.96, 95% CI 1.29–2.97, P = 0.002), and positive margins (HR 3.67, 95% CI 2.40–5.62, P < 0.001) were independent poor prognostic factors for OS. The interaction effects between the dissection style and each independent factor were not significant for OS, LRFS, RRFS, or DMFS (P > 0.05). Furthermore, no survival differences were found between SND and CND in the case‐matched cohort in terms of OS, LRFS, RRFS, or DMFS (P = 0.550, 0.930, 0.214, and 0.146, respectively). Conclusion With a similar radical dissection extent around the tumor rather than dissection of extensive lymph region distal to the lesion, SND is not inferior to CND for patients with NPC with only cervical failure. ECS, rN stage, and positive margins were adverse independent prognostic factors for patients with NPC. Level of Evidence 4 Laryngoscope, 129:387–395, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgery for isolated regional failure in nasopharyngeal carcinoma after radiation: Selective or comprehensive neck dissection

Liu

You

et al. 2018

The Laryngoscope

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“…Contraindications for nasopharyngectomy include invasion of the cavernous sinus, skull base erosion, intradural or intracranial invasion and pharyngobasilar fascia invasion; although it increases morbidity, a second course of preoperative radiotherapy is not considered an absolute contraindication 44,45 . Residual cervical lymph node disease can be managed by selective neck dissection when a single infracentimetric positive node is present or by radical neck dissection and individualised imaging-based modified neck dissection 46,47 . Palliative surgery including tumour debulking, electrocoagulation for epistaxis or myringotomy with grommet insertion for otitis media with effusion might alleviate symptoms, although the latter has been shown to increase the risk of difficult to manage otorrhea 48 .…”

Section: Nasopharyngeal Cancermentioning

confidence: 99%

Difficulties in the surgical management of head and neck cancer patient

Sarafoleanu

Vuzitas

Manea

2017

Romanian Journal of Rhinology

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Malignancies of the upper aerodigestive tract are high morbidity bearing and life-threatening diseases, which require thorough care from diagnostic suspicion and confirmation to surgical and/or oncologic treatment and rehabilitation. Difficulties in managing head and neck cancers arise from delays in diagnosis and treatment caused by either patient-related factors or healthcare system-related factors. Tumor origin and stage determine whether surgical excision is feasible, the approach required for safe excision, the extent of functional and aesthetic sacrifice required to attain oncologic safety and the need for reconstructive surgery. A thorough and systematic preoperative risk versus benefits assessment to select potential surgical candidates and give realistic outcomes is important from both a medical and a legal point of view. Because tumors in the head and neck region frequently involve more than one system and sensory organ, potential loss of function from either the disease course, surgical or nonsurgical treatment should be taken into account form a quality of life perspective. Effective management of head and neck cancer patients requires the cooperation and combined effort of a multidisciplinary team of surgeons, physicians and other workers over a long period of time which, in the absence of a specialised head and neck cancer centre and guidelines, can lead to increased morbidity and mortality, and patient dissatisfaction.

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“…Whether such an extensive operation such as RND is truly necessary to achieve control of the neck disease is highly debatable, as cervical metastases in rNPC frequently present as a solitary node, and, sometimes, subsequent examination of the radical neck dissection specimen reveals no tumor in any of the lymph nodes removed [69]. Some authors suggest that as the neck nodes in level I are affected only in 4-5% of the patients with regionally recurrent NPC, a less extensive RND sparing level I might be considered [64,70,71].…”

Section: Neck Dissectionmentioning

confidence: 99%

Recurrent Nasopharyngeal Cancer: Critical Review of Local Treatment Options Including Recommendations during the COVID-19 Pandemic

Švajdová

Obtulovičová

Dubinský

et al. 2020

Cancers

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Recurrent nasopharyngeal carcinoma represents an extremely challenging therapeutic situation. Given the vulnerability of the already pretreated neurological structures surrounding the nasopharynx, any potential salvage retreatment option bears a significant risk of severe complications that result in high treatment-related morbidity, quality of life deterioration, and even mortality. Yet, with careful patient selection, long-term survival may be achieved after local retreatment in a subgroup of patients with local or regional relapse of nasopharyngeal cancer. Early detection of the recurrence represents the key to therapeutic success, and in the case of early stage disease, several curative treatment options can be offered to the patient, albeit with minimal support in prospective clinical data. In this article, an up-to-date review of published evidence on modern surgical and radiation therapy treatment options is summarized, including currently recommended treatment modifications of both therapeutic approaches during the coronavirus disease 2019 pandemic.

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Selective neck dissection for neck residue of nasopharyngeal carcinoma: A prospective study

Cited by 11 publications

References 22 publications

Surgery for isolated regional failure in nasopharyngeal carcinoma after radiation: Selective or comprehensive neck dissection

Surgery for isolated regional failure in nasopharyngeal carcinoma after radiation: Selective or comprehensive neck dissection

Difficulties in the surgical management of head and neck cancer patient

Recurrent Nasopharyngeal Cancer: Critical Review of Local Treatment Options Including Recommendations during the COVID-19 Pandemic

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