Treatment outcome of n3 nodal head and neck squamous cell carcinoma

Chan, Sor Way

doi:10.1016/s0194-5998(03)00477-7

Cited by 16 publications

(14 citation statements)

References 15 publications

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“…Those with less than five pathologically positive nodes, despite having N3‐stage disease, had a 5‐year DFS of over 96% (95% CI: 88%–100%); whereas, those with five or more positive nodes had a 5‐year DFS of 64% (95% CI: 38%–90%). Finally, the addition of adjuvant therapy is a critical feature of management of patients with bulky nodal disease, and surgery alone has been shown to result in high regional recurrence rates …”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgically treated human papillomavirus–related oropharyngeal squamous cell carcinoma with N3 disease

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Outcomes of surgically treated human papillomavirus–related oropharyngeal squamous cell carcinoma with N3 disease

et al. 2016

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“…Chan et al 19 classified patients into four groups depending on the treatment received: (i) those treated with neck dissection followed by radiotherapy; (ii) those who had a pre-operative radiotherapy followed by planned neck dissection surgery; (iii) those who were treated only with neck dissection surgery due to a refusal to have radiotherapy or who died before radiotherapy; and (iv) those who had preor postoperative chemotherapy with or without chemotherapy. All patients had squamous cell carcinoma of the head and neck and advanced neck disease (N3).…”

Section: Literature Reviewmentioning

confidence: 99%

“…A combination of radical neck dissec- Surgery and postoperative radiotherapy ---3 8.9 Carvalho et al 19 Surgery and postoperative radiotherapy 69.2 -2 6.9 -Smeele et al 20 Surgery and postoperative radiotherapy -4 91 -- Table 1 Summary of disease-specific survival rates from the literature tion, extended radical neck dissection and selective neck dissections. In 88.9% of these patients, adjuvant radiotherapy was performed.…”

Section: Literature Reviewmentioning

confidence: 99%

Outcomes in Squamous Cell Carcinoma with Advanced Neck Disease

Keir

Whiteside

Winter

et al. 2007

annals

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INTRODUCTION Treatment of advanced neck disease (N2c/N3) in head and neck squamous cell carcinoma is contentious. The aim of this study was to review the survival outcome following surgical excision of neck disease and the complications of this surgery. PATIENTS AND METHODS A retrospective review of the case notes of 39 patients treated at the Oxford Radcliffe Infirmary Head and Neck Unit with squamous cell carcinoma and advanced neck metastases confirmed as either pN2c or pN3 on histological examination was performed. Patients were treated with surgery and, in some cases, with adjunctive postoperative radiotherapy at the centre between August 1996 and November 2004. The study sought to establish the demographics, UICC staging/pathology, method of treatment, complications, recurrence and survival. Kaplan-Meier curves were used for statistical analysis of survival. Comparisons were then made between the cohort and historical control groups. RESULTS All patients were UICC stage IV disease. The 2- and 5-year overall survival in patients with resectable disease was 63% and 52%, respectively. DISCUSSION Patients with advanced neck disease have traditionally been thought to have terrible prognosis and, therefore, treatment is controversial. In treating advanced head and neck cancer, there has been a recent trend away from surgery towards chemotherapy and/or radiotherapy. CONCLUSIONS Comparing this study group to historical controls that include chemotherapy and/or radiotherapy, the outcomes appear favourable. The use of a combination of radiotherapy and surgery is advocated; it is suggested that advanced neck disease can have an acceptable prognosis and morbidity and that local disease control may be achieved.

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“…A retrospective non- randomized study showed that the 5-year survival rate was significantly higher for those who had postoperative radiotherapy (38.9%) compared with patients who had pre-operative radiotherapy (9.1%) and those having surgery alone (0%). They were unable to evaluate the role of definitive chemotherapy and/or radiotherapy and salvage surgery as the results were inconsistent and the available data was limited [44]. …”

Section: Management Of Positive Neck Nodesmentioning

confidence: 99%

Neck dissections: radical to conservative

Harish

2005

World J Surg Onc

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Background: Neck dissection is an important surgical procedure for the management of metastatic nodal disease in the neck. The gold standard of neck nodal management has been the radical neck dissection. Any modification in the neck dissection is always compared with this standard. Over the last few decades, in order to alleviate the morbidity of radical neck dissection, several modifications and conservative procedures have been advocated. These procedures retain certain lymphatic or non-lymphatic structures and have been shown not to compromise oncological safety. Methods:A literature search of the Medline was carried out for all articles on neck dissections. The articles were systematically reviewed to analyze and trace the evolution of neck dissection. These were then categorized to address the nomenclature, management of node positive and node negative neck including those who had received chemoradiation. Results:The present article discusses the neck nodal nomenclature, the radical neck dissection, its modifications and migration to more conservative procedures and possible advances in the near future. Conclusion:Radical neck dissection is now replaced with modified radical neck dissections in most situations. Attempts are being made to replace modified radical neck dissections with selective neck dissections for early node positivity. Sentinel node biopsy is being studied to address the issue of node negative neck. More conservative surgeries are likely to replace the 'radical' surgeries of bygone era. This process is facilitated by earlier detection of the disease and better understanding of cancer biology.

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Treatment outcome of n3 nodal head and neck squamous cell carcinoma

Cited by 16 publications

References 15 publications

Outcomes of surgically treated human papillomavirus–related oropharyngeal squamous cell carcinoma with N3 disease

Outcomes of surgically treated human papillomavirus–related oropharyngeal squamous cell carcinoma with N3 disease

Outcomes in Squamous Cell Carcinoma with Advanced Neck Disease

Neck dissections: radical to conservative

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