Our results strongly support the use of PET-CT imaging as the more cost-effective strategy for surveillance of neck after completion of definitive CRT compared to up-front neck dissection.
Planned neck dissection can be deferred with a negative post-treatment PET-CT. Assuming a complete response at the primary site and a negative PET-CT scan, there may be a role for serial PET-CT surveillance in patients with residual palpable cervical lymphadenopathy. Laryngoscope, 2009.
ObjectiveTo study the retropharyngeal lymph node status (RPLN) by pretreatment PET-CT imaging in patients with squamous cell carcinomas of the oropharynx (OPSCC). Study Design: Retrospective.Methods101 patients with a biopsy proven OPSCC were identified. 53 patients meeting inclusion criteria were further analyzed.ResultsThe frequency of RPLN was 20.8% (11/53). Advanced T stage cancer (OR = 5.6250, 95% CI: 1.06 - 29.80, p = 0.0410) and advanced clinical N stage cancer (i.e. N2+) had higher odds (OR = 3.9773, 95% CI: 0.9628 - 16.4291) of being RPLN positive as compared to N0-1 patients.ConclusionsPre-treatment PET-CT can be used as a staging tool to aid in treatment planning of OPSCC, as rates of RPLN and nodal metastasis are consistent with those reported in the literature. Advanced T and N stage are associated with a greater odds ratio of being RPLN positive by PET-CT imaging.
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