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Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer.

Publication ,  Journal Article
Langerman, A; Plein, C; Vokes, EE; Salama, JK; Haraf, DJ; Blair, EA; Stenson, KM
Published in: Arch Otolaryngol Head Neck Surg
November 2009

OBJECTIVE: The role of neck dissection following chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer is an area of active debate. Patients who have a complete radiographic response may not need dissection, and the extent of neck dissection necessary for those patients with residual disease is unclear. DESIGN: Retrospective review of data from a prospectively collected database of patients with locoregionally advanced head and neck cancer treated as part of a phase 2 study of induction chemotherapy followed by concurrent CRT. The results of post-CRT neck computed tomography (CT) imaging and pathologic analysis of the neck dissection specimens were compared to evaluate correlation between radiographic and pathologic response. RESULTS: Forty-nine patients underwent 61 hemineck dissections. Overall, 209 neck levels were dissected. Radiologic complete response in the neck was achieved in 39 patients, all of whom had pathologic specimens negative for tumor cells. Ten patients (20%) had a total of 14 neck levels with residual disease on CT imaging. Five (50%) of these 10 patients were found to have residual tumor cells on pathologic analysis. Tumor cells were contained only to those levels found positive on CT imaging; they were present in 7 (50%) of the 14 positive levels. CONCLUSIONS: Neck levels with residual disease on post-CRT CT imaging warrant removal. However, neck levels without evidence of disease on post-CRT CT imaging are unlikely to harbor cancer, which lends further support to the concept of basing neck dissection on post-CRT staging and performance of limited neck dissections for patients with limited residual disease.

Duke Scholars

Published In

Arch Otolaryngol Head Neck Surg

DOI

EISSN

1538-361X

Publication Date

November 2009

Volume

135

Issue

11

Start / End Page

1133 / 1136

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Otorhinolaryngology
  • Neoplasm Staging
  • Neck Dissection
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans
  • Head and Neck Neoplasms
 

Citation

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Langerman, A., Plein, C., Vokes, E. E., Salama, J. K., Haraf, D. J., Blair, E. A., & Stenson, K. M. (2009). Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer. Arch Otolaryngol Head Neck Surg, 135(11), 1133–1136. https://doi.org/10.1001/archoto.2009.154
Langerman, Alexander, Colleen Plein, Everett E. Vokes, Joseph K. Salama, Daniel J. Haraf, Elizabeth A. Blair, and Kerstin M. Stenson. “Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer.Arch Otolaryngol Head Neck Surg 135, no. 11 (November 2009): 1133–36. https://doi.org/10.1001/archoto.2009.154.
Langerman A, Plein C, Vokes EE, Salama JK, Haraf DJ, Blair EA, et al. Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 2009 Nov;135(11):1133–6.
Langerman, Alexander, et al. “Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer.Arch Otolaryngol Head Neck Surg, vol. 135, no. 11, Nov. 2009, pp. 1133–36. Pubmed, doi:10.1001/archoto.2009.154.
Langerman A, Plein C, Vokes EE, Salama JK, Haraf DJ, Blair EA, Stenson KM. Neck response to chemoradiotherapy: complete radiographic response correlates with pathologic complete response in locoregionally advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 2009 Nov;135(11):1133–1136.

Published In

Arch Otolaryngol Head Neck Surg

DOI

EISSN

1538-361X

Publication Date

November 2009

Volume

135

Issue

11

Start / End Page

1133 / 1136

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Otorhinolaryngology
  • Neoplasm Staging
  • Neck Dissection
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans
  • Head and Neck Neoplasms