Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation
Objective: Determine prevalence of viable malignancy in patients undergoing neck dissection (ND) for residual neck disease following concomitant chemotherapy and irradiation (chemo/xrt) for upper aerodigestive squamous carcinoma. To determine survival in groups with a neck complete response to those...
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| Veröffentlicht in: | The Laryngoscope 2011-08, Vol.121 (8), p.1656-1661 |
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| creator | Dooley, Laura M. Potts, Kevin L. Wilson, Liz D. Cappello, Zachary J. Bumpous, Jeffrey M. |
| description | Objective:
Determine prevalence of viable malignancy in patients undergoing neck dissection (ND) for residual neck disease following concomitant chemotherapy and irradiation (chemo/xrt) for upper aerodigestive squamous carcinoma. To determine survival in groups with a neck complete response to those who had residual disease requiring neck dissection.
Study Design:
Retrospective chart review.
Methods:
Retrospective chart review of 230 patients who underwent definitive chemo/xrt for primary squamous cell carcinoma cancer (SCCa) of the head and neck from 2005 to 2009 in one institution.
Results:
Thirty‐nine (17%) patients underwent ND for residual neck mass within 4 months posttreatment. Forty‐nine percent (19/39) were pathologically positive for malignancy and 51% (20/39) were negative. The probability of a +ND based on original N‐stage was not statistically significant (P = .368). Primary site did not yield significant probability of having +ND, except in the oral cavity (P = .02). Patients had similar overall 5‐year survival, among those with a delayed complete response in the neck (66%), ND for residual disease (71%), or those with initial complete response (71%). Lower initial N‐stage demonstrated improved survival in all outcome groups. Tonsil SCCa patients who underwent ND had improved survival compared to those with delayed complete response (87.5 vs. 75.8%), both of which had increased survival compared to initial complete responders (65%).
Conclusions:
This study supports the use of ND in the postchemo/xrt positive neck regardless of primary site or initial N‐stage. ND in this setting conveys survival equal to patients with complete response in the neck after chemo/xrt. These survivorship implications of postchemo/xrt neck dissection extend to all sites, including tonsils. |
| doi_str_mv | 10.1002/lary.21888 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_879677832</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>879677832</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4248-ac55020319eb5dca33cacabd16eda2355f467a5a09f86f197d0d89834fe610df3</originalsourceid><addsrcrecordid>eNp90F1rFDEUBuBBFLtWb_wBEhARhKk5yWSSuSxFq7AoaMV6Fc4mJzTtfKzJjLr_3llnW8ELrwLJ854T3qJ4CvwEOBevW0y7EwHGmHvFCpSEsmoadb9YzY-yNEpcHhWPcr7mHLRU_GFxJKAWtQJYFfYiEY4d9SMbptENHbHYs_GKWKIc_YRtu2PbIccx_iDWk7thGEZKzFOI_XLrrqgb5kjC7Y5h71lMCX3EMQ794-JBwDbTk8N5XHx5--bi7F25_nj-_ux0XbpKVKZEpxQXXEJDG-UdSunQ4cZDTR6FVCpUtUaFvAmmDtBoz71pjKwC1cB9kMfFy2XuNg3fJ8qj7WJ21LbY0zBla3RTa22kmOXzf-T1MKV-_pwFA6BUBXyvXi3KpSHnRMFuU-zmoi1wu2_d7lu3f1qf8bPDyGnTkb-jtzXP4MUBYHbYhoS9i_mvqyrBQewdLO5nbGn3n5V2ffrp2-3ycsnEPNKvuwymG1trqZX9-uHcXkr9WWgJ1sjfKzGp1A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1811554102</pqid></control><display><type>article</type><title>Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Dooley, Laura M. ; Potts, Kevin L. ; Wilson, Liz D. ; Cappello, Zachary J. ; Bumpous, Jeffrey M.</creator><creatorcontrib>Dooley, Laura M. ; Potts, Kevin L. ; Wilson, Liz D. ; Cappello, Zachary J. ; Bumpous, Jeffrey M.</creatorcontrib><description>Objective:
Determine prevalence of viable malignancy in patients undergoing neck dissection (ND) for residual neck disease following concomitant chemotherapy and irradiation (chemo/xrt) for upper aerodigestive squamous carcinoma. To determine survival in groups with a neck complete response to those who had residual disease requiring neck dissection.
Study Design:
Retrospective chart review.
Methods:
Retrospective chart review of 230 patients who underwent definitive chemo/xrt for primary squamous cell carcinoma cancer (SCCa) of the head and neck from 2005 to 2009 in one institution.
Results:
Thirty‐nine (17%) patients underwent ND for residual neck mass within 4 months posttreatment. Forty‐nine percent (19/39) were pathologically positive for malignancy and 51% (20/39) were negative. The probability of a +ND based on original N‐stage was not statistically significant (P = .368). Primary site did not yield significant probability of having +ND, except in the oral cavity (P = .02). Patients had similar overall 5‐year survival, among those with a delayed complete response in the neck (66%), ND for residual disease (71%), or those with initial complete response (71%). Lower initial N‐stage demonstrated improved survival in all outcome groups. Tonsil SCCa patients who underwent ND had improved survival compared to those with delayed complete response (87.5 vs. 75.8%), both of which had increased survival compared to initial complete responders (65%).
Conclusions:
This study supports the use of ND in the postchemo/xrt positive neck regardless of primary site or initial N‐stage. ND in this setting conveys survival equal to patients with complete response in the neck after chemo/xrt. These survivorship implications of postchemo/xrt neck dissection extend to all sites, including tonsils.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.21888</identifier><identifier>PMID: 21626511</identifier><identifier>CODEN: LARYA8</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Biological and medical sciences ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - radiotherapy ; Carcinoma, Squamous Cell - surgery ; Chemotherapy ; Dermatology ; Dissection ; Head and neck cancer ; Head and Neck Neoplasms - drug therapy ; Head and Neck Neoplasms - mortality ; Head and Neck Neoplasms - radiotherapy ; Head and Neck Neoplasms - surgery ; Humans ; Level of Evidence: 2c ; Lymphatic Metastasis ; Medical sciences ; Neck Dissection ; Neoplasm, Residual ; Otorhinolaryngology (head neck, general aspects and miscellaneous) ; Otorhinolaryngology. Stomatology ; squamous cell carcinoma ; Survival Analysis ; Survival Rate ; Tumors ; Tumors of the skin and soft tissue. Premalignant lesions</subject><ispartof>The Laryngoscope, 2011-08, Vol.121 (8), p.1656-1661</ispartof><rights>Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4248-ac55020319eb5dca33cacabd16eda2355f467a5a09f86f197d0d89834fe610df3</citedby><cites>FETCH-LOGICAL-c4248-ac55020319eb5dca33cacabd16eda2355f467a5a09f86f197d0d89834fe610df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.21888$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.21888$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24420121$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21626511$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dooley, Laura M.</creatorcontrib><creatorcontrib>Potts, Kevin L.</creatorcontrib><creatorcontrib>Wilson, Liz D.</creatorcontrib><creatorcontrib>Cappello, Zachary J.</creatorcontrib><creatorcontrib>Bumpous, Jeffrey M.</creatorcontrib><title>Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objective:
Determine prevalence of viable malignancy in patients undergoing neck dissection (ND) for residual neck disease following concomitant chemotherapy and irradiation (chemo/xrt) for upper aerodigestive squamous carcinoma. To determine survival in groups with a neck complete response to those who had residual disease requiring neck dissection.
Study Design:
Retrospective chart review.
Methods:
Retrospective chart review of 230 patients who underwent definitive chemo/xrt for primary squamous cell carcinoma cancer (SCCa) of the head and neck from 2005 to 2009 in one institution.
Results:
Thirty‐nine (17%) patients underwent ND for residual neck mass within 4 months posttreatment. Forty‐nine percent (19/39) were pathologically positive for malignancy and 51% (20/39) were negative. The probability of a +ND based on original N‐stage was not statistically significant (P = .368). Primary site did not yield significant probability of having +ND, except in the oral cavity (P = .02). Patients had similar overall 5‐year survival, among those with a delayed complete response in the neck (66%), ND for residual disease (71%), or those with initial complete response (71%). Lower initial N‐stage demonstrated improved survival in all outcome groups. Tonsil SCCa patients who underwent ND had improved survival compared to those with delayed complete response (87.5 vs. 75.8%), both of which had increased survival compared to initial complete responders (65%).
Conclusions:
This study supports the use of ND in the postchemo/xrt positive neck regardless of primary site or initial N‐stage. ND in this setting conveys survival equal to patients with complete response in the neck after chemo/xrt. These survivorship implications of postchemo/xrt neck dissection extend to all sites, including tonsils.</description><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - radiotherapy</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Chemotherapy</subject><subject>Dermatology</subject><subject>Dissection</subject><subject>Head and neck cancer</subject><subject>Head and Neck Neoplasms - drug therapy</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Humans</subject><subject>Level of Evidence: 2c</subject><subject>Lymphatic Metastasis</subject><subject>Medical sciences</subject><subject>Neck Dissection</subject><subject>Neoplasm, Residual</subject><subject>Otorhinolaryngology (head neck, general aspects and miscellaneous)</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>squamous cell carcinoma</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Tumors</subject><subject>Tumors of the skin and soft tissue. Premalignant lesions</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90F1rFDEUBuBBFLtWb_wBEhARhKk5yWSSuSxFq7AoaMV6Fc4mJzTtfKzJjLr_3llnW8ELrwLJ854T3qJ4CvwEOBevW0y7EwHGmHvFCpSEsmoadb9YzY-yNEpcHhWPcr7mHLRU_GFxJKAWtQJYFfYiEY4d9SMbptENHbHYs_GKWKIc_YRtu2PbIccx_iDWk7thGEZKzFOI_XLrrqgb5kjC7Y5h71lMCX3EMQ794-JBwDbTk8N5XHx5--bi7F25_nj-_ux0XbpKVKZEpxQXXEJDG-UdSunQ4cZDTR6FVCpUtUaFvAmmDtBoz71pjKwC1cB9kMfFy2XuNg3fJ8qj7WJ21LbY0zBla3RTa22kmOXzf-T1MKV-_pwFA6BUBXyvXi3KpSHnRMFuU-zmoi1wu2_d7lu3f1qf8bPDyGnTkb-jtzXP4MUBYHbYhoS9i_mvqyrBQewdLO5nbGn3n5V2ffrp2-3ycsnEPNKvuwymG1trqZX9-uHcXkr9WWgJ1sjfKzGp1A</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Dooley, Laura M.</creator><creator>Potts, Kevin L.</creator><creator>Wilson, Liz D.</creator><creator>Cappello, Zachary J.</creator><creator>Bumpous, Jeffrey M.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201108</creationdate><title>Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation</title><author>Dooley, Laura M. ; Potts, Kevin L. ; Wilson, Liz D. ; Cappello, Zachary J. ; Bumpous, Jeffrey M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4248-ac55020319eb5dca33cacabd16eda2355f467a5a09f86f197d0d89834fe610df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - radiotherapy</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Chemotherapy</topic><topic>Dermatology</topic><topic>Dissection</topic><topic>Head and neck cancer</topic><topic>Head and Neck Neoplasms - drug therapy</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Humans</topic><topic>Level of Evidence: 2c</topic><topic>Lymphatic Metastasis</topic><topic>Medical sciences</topic><topic>Neck Dissection</topic><topic>Neoplasm, Residual</topic><topic>Otorhinolaryngology (head neck, general aspects and miscellaneous)</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>squamous cell carcinoma</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Tumors</topic><topic>Tumors of the skin and soft tissue. Premalignant lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dooley, Laura M.</creatorcontrib><creatorcontrib>Potts, Kevin L.</creatorcontrib><creatorcontrib>Wilson, Liz D.</creatorcontrib><creatorcontrib>Cappello, Zachary J.</creatorcontrib><creatorcontrib>Bumpous, Jeffrey M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dooley, Laura M.</au><au>Potts, Kevin L.</au><au>Wilson, Liz D.</au><au>Cappello, Zachary J.</au><au>Bumpous, Jeffrey M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2011-08</date><risdate>2011</risdate><volume>121</volume><issue>8</issue><spage>1656</spage><epage>1661</epage><pages>1656-1661</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><coden>LARYA8</coden><abstract>Objective:
Determine prevalence of viable malignancy in patients undergoing neck dissection (ND) for residual neck disease following concomitant chemotherapy and irradiation (chemo/xrt) for upper aerodigestive squamous carcinoma. To determine survival in groups with a neck complete response to those who had residual disease requiring neck dissection.
Study Design:
Retrospective chart review.
Methods:
Retrospective chart review of 230 patients who underwent definitive chemo/xrt for primary squamous cell carcinoma cancer (SCCa) of the head and neck from 2005 to 2009 in one institution.
Results:
Thirty‐nine (17%) patients underwent ND for residual neck mass within 4 months posttreatment. Forty‐nine percent (19/39) were pathologically positive for malignancy and 51% (20/39) were negative. The probability of a +ND based on original N‐stage was not statistically significant (P = .368). Primary site did not yield significant probability of having +ND, except in the oral cavity (P = .02). Patients had similar overall 5‐year survival, among those with a delayed complete response in the neck (66%), ND for residual disease (71%), or those with initial complete response (71%). Lower initial N‐stage demonstrated improved survival in all outcome groups. Tonsil SCCa patients who underwent ND had improved survival compared to those with delayed complete response (87.5 vs. 75.8%), both of which had increased survival compared to initial complete responders (65%).
Conclusions:
This study supports the use of ND in the postchemo/xrt positive neck regardless of primary site or initial N‐stage. ND in this setting conveys survival equal to patients with complete response in the neck after chemo/xrt. These survivorship implications of postchemo/xrt neck dissection extend to all sites, including tonsils.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21626511</pmid><doi>10.1002/lary.21888</doi><tpages>6</tpages></addata></record> |
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| subjects | Biological and medical sciences Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - radiotherapy Carcinoma, Squamous Cell - surgery Chemotherapy Dermatology Dissection Head and neck cancer Head and Neck Neoplasms - drug therapy Head and Neck Neoplasms - mortality Head and Neck Neoplasms - radiotherapy Head and Neck Neoplasms - surgery Humans Level of Evidence: 2c Lymphatic Metastasis Medical sciences Neck Dissection Neoplasm, Residual Otorhinolaryngology (head neck, general aspects and miscellaneous) Otorhinolaryngology. Stomatology squamous cell carcinoma Survival Analysis Survival Rate Tumors Tumors of the skin and soft tissue. Premalignant lesions |
| title | Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation |
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