Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review

Gane, Elise; Michaleff, Zoe A; Cottrell, Michelle; McPhail, Steven; Hatton, Anna L.; Panizza, Benedict; O’Leary, Shaun

doi:10.1016/j.ejso.2016.10.026

Cited by 123 publications

(117 citation statements)

References 75 publications

(130 reference statements)

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“…(11, 16, 27) Taken together, there is a persistent need for improved tumor-specific lymph node detection, particularly within the sentinel nodal basins, to decrease the incidence of unnecessary neck dissections and their associated morbidity. As such, the application of this technology has the potential to improve identification of cervical metastatic disease, which may improve outcomes in overall survival, disease-specific survival, and recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Sensitivity and Specificity of Cetuximab-IRDye800CW to Identify Regional Metastatic Disease in Head and Neck Cancer

Rosenthal

Moore

Tipirneni

et al. 2017

Clinical Cancer Research

113

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Purpose Comprehensive cervical lymphadenectomy can be associated with significant morbidity and poor quality of life. This study evaluated the sensitivity and specificity of cetuximab-IRDye800CW to identify metastatic disease in patients with head and neck cancer. Experimental Design Consenting patients scheduled for curative resection were enrolled in a clinical trial to evaluate the safety and specificity of cetuximab-IRDye800CW. Patients (n=12) received escalating doses of the study drug. Where indicated, cervical lymphadenectomy accompanied primary tumor resection, which occurred 3–7days following intravenous infusion of cetuximab-IRDye800CW. All 471 dissected lymph nodes were imaged with a closed-field, near-infrared imaging device during gross processing of the fresh specimens. Intraoperative imaging of exposed neck levels was performed with an open-field fluorescence-imaging device. Blinded assessments of the fluorescence data were compared to histopathology to calculate sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). Results Of the 35 nodes diagnosed pathologically positive, 34 were correctly identified with fluorescence imaging, yielding a sensitivity of 97.2%. Of the 435 pathologically negative nodes, 401 were correctly assessed using fluorescence imaging, yielding a specificity of 92.7%. The NPV was determined to be 99.7%, and the PPV was 50.7%. When 37 fluorescently false-positive nodes were sectioned deeper (1mm) into their respective blocks, metastatic cancer was found in 8.1% of the re-cut nodal specimens, which altered staging in two of those cases. Conclusions Fluorescence imaging of lymph nodes after systemic cetuximab-IRDye800CW administration demonstrated high sensitivity and was capable of identifying additional positive nodes on deep sectioning.

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Section: Discussionmentioning

confidence: 99%

“…(15) The marginal mandibular nerve and the accessory nerve are often injured during neck dissection. (16) Modified radical neck dissection and selective neck dissection are known to be associated with poor quality of life. (17–19)…”

Section: Introductionmentioning

confidence: 99%

Sensitivity and Specificity of Cetuximab-IRDye800CW to Identify Regional Metastatic Disease in Head and Neck Cancer

Rosenthal

Moore

Tipirneni

et al. 2017

Clinical Cancer Research

113

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“…4 Another retrospective review of 352 patients with OPSCC treated with bilateral neck dissection revealed that T1 and T2 tonsil primaries had a frequency of bilateral lymph node metastases of 6.3% and 17.5%, respectively, and T1 and T2 tongue base tumors had rates of 20.0% and 31.5%, respectively. [7][8][9] In addition, patients can suffer shoulder impairment that impacts their quality of life. 6 The morbidities of elective neck treatment can be significant.…”

Section: Introductionmentioning

confidence: 99%

Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique

et al. 2019

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Background: Risk of contralateral nodal metastases in oropharyngeal squamous cell carcinoma (OPSCC) is currently based on clinical risk factors. We propose lymphatic mapping with single photon emission computed tomography (SPECT-CT) for tumor-specific delineation of lymphatic drainage to guide treatment.Methods: Retrospective review of lymphatic drainage patterns in cT1-2 OPSCC and contralateral cN0 neck with a nonoperative, awake injection of 99 m-Tc sulfur colloid and SPECT-CT. Results: Ten patients were reviewed. Primary sites included tonsil (n = 8, 80%) and tongue base (n = 2, 20%). All patients tolerated awake injections with no complications. Nine patients (90%) demonstrated satisfactory migration of radiotracer to neck node(s) with seven (78%) to the ipsilateral lateral neck, one (11%) to the ipsilateral lateral neck and retropharynx, and one (11%) to bilateral lateral neck nodes.Conclusions: Characterization of lymphatic drainage in OPSCC is feasible using a nonoperative injection technique and SPECT-CT. Drainage to the contralateral neck is rare, warranting further study to tailor treatment appropriately. K E Y W O R D Sawake injection, lymphoscintigraphy, neck dissection, oropharyngeal squamous cell carcinoma, sentinel lymph node biopsy, SPECT-CT, transoral robotic surgery

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“…Xerostomia, or dry mouth, is among the most common symptoms experienced by head and neck cancer survivors, and radiation‐induced changes in both the quantity and quality of saliva produced predispose these patients to the development of dental caries . Additionally, many of these patients undergo removal of lymph nodes from the neck (neck dissection) as part of their treatment . As a result, they may experience a number of long‐term side effects including neck and shoulder pain and decreased range of motion, with a correlation described in the literature between the extent of neck dissection and the severity of symptoms .…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, many of these patients undergo removal of lymph nodes from the neck (neck dissection) as part of their treatment . As a result, they may experience a number of long‐term side effects including neck and shoulder pain and decreased range of motion, with a correlation described in the literature between the extent of neck dissection and the severity of symptoms . Given the prevalence of these issues and their potentially significant impact on long‐term QOL, it has been recommended that head and neck cancer patients be counseled about both potential problems with dental health and potential shoulder‐neck dysfunction prior to treatment …”

Section: Introductionmentioning

confidence: 99%

Patient‐reported outcomes for dental health, shoulder‐neck dysfunction, and overall quality of life after treatment with radiation for head and neck cancer

Verma

Tan

Knowles

et al. 2019

Laryngoscope Investig Oto

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Objectives The current exploratory cross‐sectional study was designed to examine and characterize survivorship issues among patients treated with radiation for head and neck cancer with regard to dental health, shoulder‐neck dysfunction, and overall quality of life (QOL). Methods Patients (N = 58) being seen for follow‐up at a radiation oncology clinic at least 1 year beyond the end of treatment completed three survey questionnaires regarding general QOL as well as dental health issues and shoulder‐neck dysfunction. The questionnaires were scored and univariate analyses were performed using the variables of age, radiation dosage, definitive radiation + neck dissection versus definitive surgery + postoperative radiation, and chemotherapy. Results Median follow‐up was 2.5 years. Of 58 patients, 35% reported having more problems with their general dental health as compared to before treatment and 38% reported having pain at night in the neck/shoulder after treatment. With regard to pretreatment counseling, 79% of patients reported being counseled about their dental health prior to treatment, while 31% reported being counseled about possible shoulder‐neck dysfunction. Patients younger than 65, patients receiving higher doses of radiation, and patients undergoing definitive surgery + postoperative radiation reported more functional and symptomatic issues. Conclusion Patients treated with radiation for head and neck cancer face a number of survivorship issues, including problems with dental health and shoulder‐neck dysfunction, and are not necessarily thoroughly counseled about these issues prior to treatment. Patients younger than 65, patients receiving higher doses of radiation, and patients undergoing definitive surgery + postoperative radiation may experience more survivorship issues. Level of Evidence IV

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Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review

Cited by 123 publications

References 75 publications

Sensitivity and Specificity of Cetuximab-IRDye800CW to Identify Regional Metastatic Disease in Head and Neck Cancer

Sensitivity and Specificity of Cetuximab-IRDye800CW to Identify Regional Metastatic Disease in Head and Neck Cancer

Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique

Patient‐reported outcomes for dental health, shoulder‐neck dysfunction, and overall quality of life after treatment with radiation for head and neck cancer

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