Control of nodal metastases in squamous cell head and neck cancer treated by radiation therapy or chemoradiation

Vergeer, Marije R.; Doornaert, P.; Leemans, C. René; Buter, Jan; Slotman, Ben J.; Langendijk, Johannes A.

doi:10.1016/j.radonc.2006.03.008

Cited by 37 publications

(29 citation statements)

References 20 publications

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“…On the basis of the same radiologic definition, we demonstrated that nodal control and survivals were significantly associated with central necrosis, as described in previous studies (8,18). Interestingly, our data also showed that radiologic central necrosis was positively associated with several CT and PET/CT parameters including N-GTV, SUV max , and N-TLG.…”

Section: Discussionsupporting

confidence: 87%

“…Previous studies showed that nodal size, radiologic signs of extranodal spread, and central necrosis are prognostic factors for regional control (8,9,(16)(17)(18). Through comprehensive CT-and PET/CT-related T-TLG40% 5 pretreatment primary TLG defined by 40% of SUV max ; T-SUV max 5 pretreatment maximum SUV of primary tumor; T-MTV2.5 5 pretreatment primary metabolic tumor volume defined by SUV 5 2.5.…”

Section: Discussionmentioning

confidence: 99%

“…However, several studies advocated surveillance of neck diseases because a complete remission can be achieved when assessing the response using 18 F-FDG PET (4)(5)(6)(7). In patients with regional recurrence after chemoradiotherapy/radiotherapy, salvage neck dissection would be possible but was associated with additional morbidity and worse prognosis (8,9). Therefore, there is a need to identify pretreatment predictors that can foresee the outcome earlier when a decision of organ preservation or treatment modification should be discussed.…”

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confidence: 99%

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Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

et al. 2015

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The aim of this study was to investigate the prognostic impact of CT and 18 F-FDG PET/CT on the outcome of metastatic neck node (MNN) in patients with head and neck cancer receiving definitive radiotherapy or chemoradiotherapy. Methods: This patient-based study included 91 patients diagnosed with pharyngeal cancers with MNN (N1, 15; N2, 70; N3, 6). All had pretreatment CT and PET/CT before definitive chemoradiotherapy/radiotherapy. Parameters of MNNs for each patient, including maximal diameter, nodal volume, radiologic central necrosis, maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG), were retrieved for the analysis. Nodal relapse-free survival (NRFS) and survivals were calculated using the Kaplan-Meier method. Independent predictors were identified using Cox regression analysis. Results: After a median follow-up of 18 mo, 64 patients remained nodal relapse-free, and 27 experienced neck recurrence. Multivariate analysis showed that the application of 40% of the maximal uptake of nodal TLG (N-TLG40%) 38 g or greater (P 5 0.03; hazard ratio, 2.63; 95% confidence interval, 1.10-6.30) and radiologic necrosis on CT scan (P 5 0.001; hazard ratio, 10.99; 95% confidence interval, 2.56-47.62) were 2 adverse features for NRFS. Patients who had an N-TLG40% 38 g or greater and central radiologic necrosis had a significantly inferior 2-y NRFS (53% vs. 77% and 45% vs. 95%, respectively). Conclusion: The outcome of MNNs in patients with head and neck cancer receiving chemoradiotherapy/radiotherapy can be predicted according to radiologic necrosis and N-TLG40% value. The 2 adverse features should be validated in future trials. In this way, patients can be treated alternatively or aggressively.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

et al. 2015

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“…40,41 However, it is unclear whether nodal volume predicts survival in patients with head and neck cancers. While some studies suggested deteriorating regional control 42,43 and worse disease-specific survival 44 in patients with large nodes, other studies did not find any relationship between nodal volume and disease-specific survival. 45,46 These contradictory studies indicate that measurement of tumor volume may not be sensitive in predicting the long-term prognosis and survival in patients with HNSCC.…”

Section: Discussionmentioning

confidence: 96%

Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

Chawla¹,

Kim²,

Loevner³

et al. 2011

AJNR Am J Neuroradiol

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“…In recent studies, MNV and primary tumor volume were reported to play important roles in predicting prognosis [8,9,20,21]. In an analysis of 79 HNSCC patients who underwent primary irradiation or chemoradiation, MNV was the most important prognostic factor for the control of pathological nodes in the neck [20]. Another study on 94 HNSCC patients showed that not only the total tumor volume (primary tumor volume plus MNV) but also the MNV were significant prognostic factors for OS [21].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Metastatic Nodal Volume and Lymph Node Ratio in Patients with Cervical Lymph Node Metastases from an Unknown Primary Tumor

Park

Jung²,

Roh³

et al. 2014

Oncology

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Objective: The presence of metastatic cervical lymph nodes (MCNs) is an unfavorable prognostic factor in head and neck cancer. The total volume of MCNs (MNV) and the lymph node ratio (LNR) may be superior to conventional nodal staging in cervical metastasis from an unknown primary tumor (CUP). We evaluated the prognostic value of MNV and LNR in CUP patients. Methods: Thirty-nine patients with CUP who underwent surgery plus postoperative radiotherapy were reviewed. MNV was measured by preoperative computed tomography and LNR was determined using neck dissection samples. The association of clinicopathologic factors, MNV, and LNR with disease-free survival (DFS) and overall survival (OS) was analyzed. Results: Five-year DFS and OS were 68.4 and 70.8%, respectively, for a median follow-up of 49 months. In multivariate analysis, MNV (>30 ml) was an independent prognostic factor for both DFS and OS (p = 0.004 and p < 0.001, respectively). LNR (>0.14) was identified as an independent predictive factor for DFS (p = 0.041). Conclusion: MNV and LNR are independent prognostic factors in patients with CUP and could facilitate the identification of high-risk patients requiring intensive treatment and surveillance.

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Control of nodal metastases in squamous cell head and neck cancer treated by radiation therapy or chemoradiation

Cited by 37 publications

References 20 publications

Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

Risk Stratification of Metastatic Neck Nodes by CT and PET in Patients with Head and Neck Cancer Receiving Definitive Radiotherapy

Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

Prognostic Value of Metastatic Nodal Volume and Lymph Node Ratio in Patients with Cervical Lymph Node Metastases from an Unknown Primary Tumor

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