Up-front neck dissection followed by definitive (chemo)-radiotherapy in head and neck squamous cell carcinoma: Rationale, complications, toxicity rates, and oncological outcomes – A systematic review

Eliçin, Olgun; Nisa, Lluís; Pra, Alan Dal; Bojaxhiu, Beat; Caversaccio, Marco; Schmücking, Michael; Aebersold, Daniel M.; Giger, Roland

doi:10.1016/j.radonc.2016.03.003

Cited by 29 publications

(19 citation statements)

References 96 publications

(231 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The need for upfront ND in the treatment of HNC is still a matter of debate. Recently, a systematic review on the subject concluded that few comparative studies suggest possible benefits of upfront neck dissection in the RT organ-preserving setting in terms of early toxicity and oncological outcome, although the level of evidence is very low [12]. Most studies on this subject have a low number of patients, do not contain information on HPV status and date from an era before concomitant CT treatment was common.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis

Nevens¹,

Duprez²,

Daisne³

et al. 2017

Radiotherapy and Oncology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis

Nevens¹,

Duprez²,

Daisne³

et al. 2017

Radiotherapy and Oncology

View full text Add to dashboard Cite

“…Such a heterogeneous behavior poses an obvious challenge to achieve simultaneous local (primary tumor) and regional (lymph node metastases) disease control. Indeed, while most early-stage (with the exception of oral squamous cell carcinoma) and some advanced-stage primaries can be usually managed by radiotherapy (with or without chemotherapy/cetuximab), presence of lymph node metastases often requires combined approaches, encompassing neck dissection and irradiation (3). Distant metastases develop in approximately 10%-30% of HNSCC patients after definitive therapy and carries a meager prognosis (approximately 5% overall 5-year survival; ref.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Genomic Profiling of Patient-matched Head and Neck Cancer Cells: A Preclinical Pipeline for Metastatic and Recurrent Disease

Nisa

Barras

Medová

et al. 2018

Molecular Cancer Research

Self Cite

View full text Add to dashboard Cite

: Metastases and tumor recurrence have a major prognostic impact in head and neck squamous cell carcinoma (HNSCC); however, cellular models that comprehensively characterize metastatic and recurrent HNSCC are lacking. To this end, we obtained genomic, transcriptomic, and copy number profiles of the UM-SCC cell line panel, encompassing patient-matched metastatic and recurrent cells. UM-SCC cells recapitulate the most prevalent genomic alterations described in HNSCC, featuring common TP53, PI3K, NOTCH, and Hippo pathway mutations. This analysis identified a novel F977Y kinase domain PIK3CA mutation exclusively present in a recurrent cell line (UM-SCC14B), potentially conferring resistance to PI3K inhibitors. Small proline-rich protein 2A (SPRR2A), a protein involved in epithelial homeostasis and invasion, was one of the most consistently downregulated transcripts in metastatic and recurrent UM-SCC cells. Assessment of SPRR2A protein expression in a clinical cohort of patients with HNSCC confirmed common SPRR2A downregulation in primary tumors (61.9% of cases) and lymph node metastases (31.3%), but not in normal tissue. High expression of SPRR2A in lymph node metastases was, along with nonoropharyngeal location of the primary tumor, an independent prognostic factor for regional disease recurrence after surgery and radiotherapy (HR 2.81; 95% CI, 1.16-6.79; = 0.02). These results suggest that SPRR2A plays a dual role in invasion and therapeutic resistance in HNSCC, respectively through its downregulation and overexpression. IMPLICATIONS: The current study reveals translationally relevant mechanisms underlying metastasis and recurrence in HNSCC and represents an adjuvant tool for preclinical research in this disease setting. Underlining its discovery potential this approach identified a PIK3CA-resistant mutation as well as SPRR2A as possible theragnostic markers.

show abstract

“…Rescue or salvage surgery after concomitant treatment failure is associated with a high rate of postoperative complications 10 , and therefore it is preferable to perform lymph node dissection first in order to reduce morbidity. This is called "upfront neck dissection", which has the virtue of offering adequate staging and a lower rate of complications in comparison with rescue dissection 11 .…”

Section: Discussionmentioning

confidence: 99%

Upfront radical neck dissection in patients cN2-3

Gallegos-Hernández¹,

Abrego-Vásquez²,

Olvera-Casas³

et al. 2022

GAMO

View full text Add to dashboard Cite

Introduction: The standard treatment of patients with metastatic squamous cell carcinoma at loco-regionally advanced stage is the association of radiation-chemotherapy; however, a high percentage of these persist and require rescue surgery, which implies significant morbidity. Initial neck dissection could play an important role in reducing this rate of complications. Objective: To know oncological results of patients with neck metastasis. Materials and methods: Retrospective analysis of patients undergoing treatment for cervical lymph node metastasis of squamous cell carcinoma. The therapeutic sequence was decided based on volume, resectability, site and size of the primary and general condition of the patient. Overall survival was calculated based on HPV status. Results: We included 30 patients with a mean age of 57 years and a mean follow-up of 5 years: 22 men and 8 women. All with loco-regionally advanced stages, 10 N3 and 20 N2. In 18, determination of p16 was made in the lymph node metastases, in 13 of them it was positive and in 5, negative. Seven patients were treated with initial chemotherapy and 23 underwent neck dissection; 5-year survival was 25% and the prognosis was better in patient with positive p16. Conclusion: The treatment of cervical metastasis depends on its resectability; initial surgery should be promoted. Neo-adjuvant chemotherapy is an alternative in patients with bulky, unresectable or borderline metastases, HPV is a factor of good prognosis.

show abstract

Up-front neck dissection followed by definitive (chemo)-radiotherapy in head and neck squamous cell carcinoma: Rationale, complications, toxicity rates, and oncological outcomes – A systematic review

Abstract: Due to lack of well-designed randomized trials, it is difficult to assess the role of UFND in organ-preserving (C)RT setting of head and neck cancer.

Cited by 29 publications

References 96 publications

Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis

Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis

Comprehensive Genomic Profiling of Patient-matched Head and Neck Cancer Cells: A Preclinical Pipeline for Metastatic and Recurrent Disease

Upfront radical neck dissection in patients cN2-3

Contact Info

Product

Resources

About