Neck dissection after radiochemotherapy in patients with locoregionally advanced head and neck cancer

Rodríguez, Mario López; Cerezo, Laura; Martín, Marta; Couñago, Felipe

doi:10.1007/s12094-008-0294-6

Cited by 14 publications

(7 citation statements)

References 24 publications

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“…In many malignant tumors, it is well known that successful treatment is correlated with an increase in ADC values (4950515253). Additionally, the ability of DWI to predict treatment outcome at one to three weeks after the start of treatment seems to be in agreement with the expected optimal timing of adjuvant neck dissection after CCRT or radiotherapy (545556).…”

Section: Discussionsupporting

confidence: 66%

Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review

et al. 2019

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ObjectiveTo systematically review the evaluation of the diagnostic accuracy of pre-treatment apparent diffusion coefficient (ADC) and change in ADC during the intra- or post-treatment period, for the prediction of locoregional failure in patients with head and neck squamous cell carcinoma (HNSCC).Materials and MethodsOvid-MEDLINE and Embase databases were searched up to September 8, 2018, for studies on the use of diffusion-weighted magnetic resonance imaging for the prediction of locoregional treatment response in patients with HNSCC treated with chemoradiation or radiation therapy. Risk of bias was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2.ResultsTwelve studies were included in the systematic review, and diagnostic accuracy assessment was performed using seven studies. High pre-treatment ADC showed inconsistent results with the tendency for locoregional failure, whereas all studies evaluating changes in ADC showed consistent results of a lower rise in ADC in patients with locoregional failure compared to those with locoregional control. The sensitivities and specificities of pre-treatment ADC and change in ADC for predicting locoregional failure were relatively high (range: 50–100% and 79–96%, 75–100% and 69–95%, respectively). Meta-analytic pooling was not performed due to the apparent heterogeneity in these values.ConclusionHigh pre-treatment ADC and low rise in early intra-treatment or post-treatment ADC with chemoradiation, could be indicators of locoregional failure in patients with HNSCC. However, as the studies are few, heterogeneous, and at high risk for bias, the sensitivity and specificity of these parameters for predicting the treatment response are yet to be determined.

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Section: Discussionsupporting

confidence: 66%

Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review

et al. 2019

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“…Cooper et al [8] have also reported that postoperative radiotherapy and chemotherapy can improve disease-free survival and improve local and regional control rate in patients with head and neck squamous cell carcinoma. López Rodríguez et al [9] have reported that preoperative radiotherapy and chemotherapy for head and neck squamous cell carcinoma at N2-N3 stage can completely control neck lymph node metastasis and achieve local and regional effectiveness.…”

Section: Discussionmentioning

confidence: 99%

The recurrence and survival of oral squamous cell carcinoma: a report of 275 cases

Wang

Zhang²,

Yue³

et al. 2013

Chin J Cancer

259

198

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Oral squamous cell carcinoma (OSCC) is a common malignant tumor of the head and neck, and recurrence is an important prognostic factor in patients with OSCC. We explored the factors associated with recurrence of OSCC and analyzed the survival of patients after recurrence. Clinicopathologic and follow-up data of 275 patients with OSCC treated by surgery in the Cancer Institute and Hospital of Tianjin Medical University between 2002 and 2006 were analyzed. Recurrence factors were analyzed with Chi-square or Fisher's exact test and multivariate analysis. The prognosis of patients after recurrence was analyzed with the Kaplan-Meier method and log-rank test. The recurrence rate was 32.7%. The recurrence time ranged from 2 to 96 months, with a median of 14 months. Univariate analysis showed that T stage, degree of differentiation, pN stage, flap application, resection margin, and lymphovascular invasion were factors of recurrence (P < 0.05). Multivariate analysis showed that T stage, degree of differentiation, and pN stage were independent factors of recurrence (P < 0.001). The differences in gender, age, tumor site, region of lymph node metastasis, and perineural invasion between the recurrence and non-recurrence groups were not significant (P > 0.05). Kaplan-Meier and log-rank tests showed that the 2- and 5-year survival rates were significantly lower in the recurrence group than in non-recurrence group (67.6% vs. 88.0%, 31.8% vs. 79.9%, P < 0.001). Therefore, to improve prognosis, we recommend extended local excision, flap, radical neck dissection, and adjuvant chemoradiotherapy for patients more likely to undergo recurrence.

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“…A potential advantage of radiation compared to surgery in this setting is that potential primary sites in the head and neck may be included in the radiation field. Neck dissection following irradiation may be required for nodal residual disease (34). A nodal excision may be sufficient when radical, comprehensive irradiation to the neck and mucosal sites is planned (30).…”

Section: Treatmentmentioning

confidence: 99%

Management of lymph node metastases from an unknown primary site to the head and neck (Review)

Zhuang

et al. 2014

Molecular and Clinical Oncology

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Abstract. Cancer of unknown primary site (CUP) is an intriguing clinical phenomenon found in ~3-9% of all head and neck cancers. It has not yet been determined whether CUP forms a distinct biological entity with specific genetic and phenotypic characteristics, or whether it is the clinical presentation of metastasis in patients with an undetected primary tumor and no visible clinical signs. The treatment of patients with cervical lymph node metastases from CUP remains controversial, due to the lack of randomized clinical trials comparing different treatment options. Consequently, treatment is currently based on non-randomized data and institutional policy. In the present review, the range and limitations of diagnostic procedures are summarized and an optimal diagnostic work-up is recommended. The initial preferred diagnostic procedures include fine-needle aspiration biopsy (FNAB) and imaging. Although neck dissection followed by postoperative radiotherapy is the the most generally accepted approach, other curative options may be used in certain patients, such as neck dissection alone, nodal excision followed by postoperative radiotherapy, or radiotherapy alone. There remains controversy regarding target radiation volumes, ranging from ipsilateral neck irradiation to prophylactic irradiation of all the potential mucosal sites and both sides of the neck. When no primary lesion is identified with imaging and endoscopy in patients without history of smoking and alcohol abuse, molecular profiling of an FNAB sample for human papillomavirus and/or Epstein-Barr virus is required.

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Neck dissection after radiochemotherapy in patients with locoregionally advanced head and neck cancer

Cited by 14 publications

References 24 publications

Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review

Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review

The recurrence and survival of oral squamous cell carcinoma: a report of 275 cases

Management of lymph node metastases from an unknown primary site to the head and neck (Review)

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