Planned neck dissection following chemoradiotherapy for advanced head and neck cancer: Is it necessary for all? Journal Article
| Authors: | Pellitteri, P. K.; Ferlito, A.; Rinaldo, A.; Shah, J. P.; Weber, R. S.; Lowry, J.; Medina, J. E.; Gourin, C. G.; Robbins, K. T.; Suárez, C.; Shaha, A. R.; Genden, E. M.; Leemans, C. R.; Lefebvre, J. L.; Kowalski, L. P.; Wel, W. I. |
| Article Title: | Planned neck dissection following chemoradiotherapy for advanced head and neck cancer: Is it necessary for all? |
| Abstract: | In the absence of large-scale randomized trials evaluating dissection versus observation of the involved neck after neoadjuvant chemoradiotherapy, there is a need to collect data that will either support or ultimately refute a role for planned posttreatment neck dissection. A significant percentage of patients with extensive (N2 or N3) neck disease who demonstrate a complete response to chemoradiation therapy may harbor residual occult metastases, and identification of this subset of patients remains a clinical challenge. Because surgical salvage rates are greatly diminished when occult nodal disease becomes clinically manifest, planned posttreatment neck dissection is advocated but may not be necessary in all patients. The role of positron emission tomography chemoradiotherapy (PET-CT) in this scenario remains unproven but holds promise in being able to identify which patients may be harboring residual disease in the neck after chemoradiotherapy. The implementation of as yet unidentified molecular tumor markers in combination with PET-CT may ultimately prove to be effective in identifying patients who will best benefit from posttherapy neck dissection. Correlation of imaging results and pathologic node status will be important in determining the accuracy and, therefore, the value of this imaging modality for predicting the presence or absence of residual disease. © 2005 Wiley Periodicals, Inc. |
| Keywords: | cancer chemotherapy; review; neck dissection; squamous cell carcinoma; carcinoma, squamous cell; advanced cancer; treatment planning; cancer adjuvant therapy; cancer radiotherapy; combined modality therapy; positron emission tomography; lymph node metastasis; antineoplastic agent; neoplasm staging; diagnostic accuracy; radiopharmaceuticals; pathology; tumor marker; patient identification; correlation coefficient; minimal residual disease; neoplasm, residual; head and neck cancer; head and neck neoplasms; fluorodeoxyglucose f18; positron-emission tomography; cervical lymph node; fluorodeoxyglucose; chemoradiotherapy; tomography, emission-computed; planned neck dissection; cervical metastasis; advanced head and neck cancer |
| Journal Title: | Head & Neck |
| Volume: | 28 |
| Issue: | 2 |
| ISSN: | 1043-3074 |
| Publisher: | John Wiley & Sons, Inc. |
| Date Published: | 2006-02-01 |
| Start Page: | 166 |
| End Page: | 175 |
| Language: | English |
| DOI: | 10.1002/hed.20302 |
| PUBMED: | 16240327 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 40" - "Export Date: 4 June 2012" - "CODEN: HEANE" - "Source: Scopus" |
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