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Is elective neck dissection indicated during salvage surgery for head and neck squamous cell carcinoma?

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Sanabria, Alvaro Silver, Carl E Olsen, Kerry D Medina, Jesus E Hamoir, Marc [UCL] Ferlito, Alfio

Among patients with head and neck squamous cell carcinoma with a negative neck who are initially treated with (chemo)radiotherapy, a number of cases will recur locally without obvious neck recurrence. There is little information available as to the most efficacious management of the neck in these cases. We have reviewed the literature to see what conclusions can be drawn from previous reports. We conducted a bibliography search on MEDLINE and EMBASE databases. Studies published in the English language and those on squamous cell carcinoma of the oral cavity, nasopharynx, oropharynx, larynx and hypopharynx were included. Data related to neck management were extracted from the articles. Twelve studies satisfied the inclusion criteria. Five studies reported only one treatment plan (either neck dissection or observation), while the others compared neck dissection to observation. The rate of occult metastases ranged from 3.4 to 12 %. The studies included a variable distribution of primary sites and stages of the recurrent primary tumors. The risk of occult neck node metastasis in a clinically rN0 patient correlated with tumor site and T stage. Observation of the neck can be suggested for patients with T1-2 glottic tumors, who recurred with less advanced tumors (rT1-2). For patients with more advanced laryngeal recurrences or recurrence at other high-risk sites, neck dissection could be considered for the rN0 patient, particularly if the neck was not included in the previous radiation fields.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès restreint
Publication date 2014
Language Anglais
Journal information "European Archives of Oto-Rhino-Laryngology" - Vol. 271, no.12, p. 3111-3119 (2014)
Peer reviewed yes
Publisher Springer ((Germany) Heidelberg)
issn 0937-4477
e-issn 1434-4726
Publication status Publié
Affiliations UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie
UCL - (SLuc) Service d'oto-rhino-laryngologie
UCL - (SLuc) Centre du cancer
MESH Subject Carcinoma, Squamous Cell ; Retrospective Studies ; Salvage Therapy ; Elective Surgical Procedures ; Head and Neck Neoplasms ; Humans ; Lymphatic Metastasis ; Neck ; Neck Dissection ; Neoplasm Recurrence, Local ; Neoplasm Staging
Links
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Bibliographic reference Sanabria, Alvaro ; Silver, Carl E ; Olsen, Kerry D ; Medina, Jesus E ; Hamoir, Marc ; et. al. Is elective neck dissection indicated during salvage surgery for head and neck squamous cell carcinoma?. In: European Archives of Oto-Rhino-Laryngology, Vol. 271, no.12, p. 3111-3119 (2014)
Permanent URL http://hdl.handle.net/2078.1/171711