Extent of neck dissection required after concurrent chemoradiation for stage IV head and neck squamous cell carcinoma.

Journal Article (Journal Article)

BACKGROUND: The management of initially bulky nodal disease after primary nonsurgical treatment for stage IV head and neck squamous cell carcinoma (HNSCC) continues to be a subject of debate. METHODS: A retrospective chart review of neck management in patients after chemoradiation was performed. RESULTS: Of the initially positive necks analyzed, 210/329 (65%) had a complete clinical response to treatment and 161 necks underwent neck surgery. Patients were pathologically positive 13.8% and 39.6% of the time after clinical complete or partial response, respectively. Regional recurrence was more frequent in necks with partial clinical (p = .04) or pathologic responses (p < .01) and with primary site recurrences (p < .01). CONCLUSIONS: It is still safest at our institution to perform selective neck dissection on patients with > or = N2 neck disease when initially observed to prevent unsalvageable regional recurrence until more accurate interval assessment tools are confirmed.

Full Text

Duke Authors

Cited Authors

  • Cannady, SB; Lee, WT; Scharpf, J; Lorenz, RR; Wood, BG; Strome, M; Lavertu, P; Esclamado, RM; Saxton, JP; Adelstein, DJ

Published Date

  • March 2010

Published In

Volume / Issue

  • 32 / 3

Start / End Page

  • 348 - 356

PubMed ID

  • 19672875

Electronic International Standard Serial Number (EISSN)

  • 1097-0347

Digital Object Identifier (DOI)

  • 10.1002/hed.21189


  • eng

Conference Location

  • United States