The Effect of Occult Nodal Metastases on Survival and Regional Control in Patients With Head and Neck Squamous Cell Carcinoma

Gourin, Christine G.; Conger, Bryant T.; Porubsky, Edward S.; Sheils, W. Chris; Bilodeau, Paul A.; Coleman, Teresa

doi:10.1097/mlg.0b013e31816e2eb7

Cited by 85 publications

(53 citation statements)

References 25 publications

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“…Therefore, lymph node status is the most important prognostic factor [56]. SLNB is feasible and reliable and this tumour therefore appears to be a good indication for SLNB [57], especially lesions with moderate or scarce differentiation.…”

Section: Indicationsmentioning

confidence: 98%

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Bluemel

Herrmann

Giammarile

et al. 2015

Eur J Nucl Med Mol Imaging

118

131

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Section: Indicationsmentioning

confidence: 98%

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Bluemel

Herrmann

Giammarile

et al. 2015

Eur J Nucl Med Mol Imaging

118

131

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“…The disease-free survival rate (a) and regional control rate (b) in the cases that were positive for extracapsular spread (ECS); solid lines indicate patients who underwent a surgical treatment at our university hospital and dashed lines indicate patients operated at other institutions. sufficient to warrant PORT, while others [14] have suggested that PORT cannot be recommended unless two or more positive nodes are found. The variability in the proposed indications for PORT raises the following question: should PORT be performed for patients with any histologically positive node or only for patients with more than three nodes?…”

Section: Discussionmentioning

confidence: 96%

“…However, the criteria for neck radiation are not yet well established. There are controversial reports about the benefits of PORT [11][12][13][14]. While some reports suggest that PORT for the neck region improves regional control, other reports suggest the opposite, especially in Nl cases [15][16][17].…”

Section: Introductionmentioning

confidence: 93%

Cervical lymph node metastasis from early-stage squamous cell carcinoma of the oral tongue

Yuasa-Nakagawa

Shibuya

Yoshimura

et al. 2013

Acta Oto-Laryngologica

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In the patients who underwent surgical treatment at our hospital, 5-year disease-free survival and regional control rates were 69.3% and 85.3%, respectively. The clinicopathologic factors significantly associated with unfavorable disease-free survival were the presence of extracapsular spread (hazard ratio (HR) = 3.005, p = 0.045), multiple and large lymph nodes (HR = 2.850, p = 0.010 and HR = 3.112, p = 0.007, respectively), younger age (HR = 2.429, p = 0.048), and shorter interval from the LD-IBT to detection of neck metastasis (HR = 1.749, p = 0.013).

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“…8 Also, the diagnosis of node metastases and the presence of extracapsular spread are considered to be an indication for adjuvant treatment. 9 On the other hand, a neck dissection may avoid unnecessary adjuvant treatment and spare the use of radiotherapy.…”

Section: Resultsmentioning

confidence: 99%

Who are the low-risk patients that could benefit from watch-and-wait regarding the neck?

Köhler

Kowalski²

2011

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: The management of clinically negative neck is controversial, with an ongoing debate on the indication criteria and prognostic impact of different types of therapy. The aim here was to compare the results from neck dissection and watch-and-wait, among oral cancer patients who, clinically, did not show any evidence of neck metastasis. DESIGN AND SETTING: Retrospective analysis in a tertiary cancer center hospital. METHODS:Patients with epidermoid oral carcinoma were assessed. The inclusion criteria were: primary tumor restricted to the oral/oropharyngeal cavity, no previous treatment, surgical treatment as the first option, clinical/radiological stage N0 and no distant metastasis. RESULTS: Two hundred and sixty-two patients were analyzed. The length of follow-up ranged from four to 369.6 months and, at the end, 118 patients were alive, 53 had died due to cancer, 84 had died from other causes and 7 had died after the operation. Among the patients who underwent neck dissection, lymphatic vascular embolization (P = 0.009) and tumor thickness (P = 0.002) were significant for regional recurrence, while for the watch-and-wait group, only tumor thickness was significant (P = 0.018). Through recursive partitioning, the patients without adverse prognostic factors and tumor thickness < 2 mm presented compatible results in the two groups. CONCLUSION: Elective neck dissection seems to be the best treatment option. Patients who are eligible for watch-and-wait constitute a small group that, ideally, is categorized according to the postoperative pathological findings.reSUMO CONTEXTO E OBJETIVO: O manejo do pescoço clinicamente negativo é controverso, havendo um debate corrente sobre os critérios de indicação bem como o impacto prognóstico das diferentes modalidades terapêuticas. O objetivo foi comparar os resultados do esvaziamento cervical com a observação em pacientes com câncer de boca e clinicamente sem evidência de metástases cervicais. TIPO DE ESTUDO E LOCAL: Análise retrospectiva em hospital terciário, especializado em oncologia. MÉTODOS: Pacientes com diagnóstico de carcinoma epidermoide de boca foram analisados. Os crité-rios de inclusão foram: tumor primário restrito à cavidade oral/orofaringe, ausência de tratamento prévio, tratamento cirúrgico como primeira opção, estádio clínico e radiológico N0 e ausência de metástases a distância. RESULTADOS: Duzentos e sessenta e dois pacientes foram analisados. O tempo de acompanhamento variou de 4 a 369.6 meses e, ao final, havia 118 pacientes vivos, 53 óbitos pela neoplasia, 84 óbitos por outras causas e 7 óbitos pós-operatórios. Nos pacientes submetidos a esvaziamento cervical, a embolização vascular linfática (P = 0,009) e a espessura tumoral (P = 0,002) foram associados significativamente com a recidiva regional, enquanto que nos pacientes somente observados, apenas a espessura tumoral se associou significativamente (P = 0,018). Por meio do particionamento recursivo, aqueles pacientes sem fatores adversos prognósticos e espessura tumoral menor...

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The Effect of Occult Nodal Metastases on Survival and Regional Control in Patients With Head and Neck Squamous Cell Carcinoma

Cited by 85 publications

References 25 publications

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma

Cervical lymph node metastasis from early-stage squamous cell carcinoma of the oral tongue

Who are the low-risk patients that could benefit from watch-and-wait regarding the neck?

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