Planned early neck dissection before radiation for persistent neck nodes after induction chemotherapy

Giovana Thomas, Jason Greenberg, Kuo Tsung Wu, Kris Moe, Ramon Esclamado, Carol Bradford, William Carroll, Avraham Eisbruch, Susan Urba, Gregory T. Wolf

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Optimal management of advanced neck metastases as part of an organ preservation treatment approach for head and neck squamous carcinoma (HNSC) is unclear. Since 1989, our management paradigm for patients on organ preservation was modified to incorporate planned early neck dissection before radiation therapy for patients who did not achieve a complete response (CR) of neck nodes after induction chemotherapy (IC). The purpose of this study was to determine if planned early neck dissection is a safe and effective approach in the management of advanced nodal disease as part of organ preservation. Fifty-eight consecutive patients with advanced HNSC who were entered in organ preservation trials using induction chemotherapy and radiation with surgical salvage were studied. Median follow-up was 26 months. Of the 58 patients, 71% were stage IV. Patients were grouped by nodal response to chemotherapy and N class, and were analyzed with respect to patterns of recurrence, complications, and survival. Overall, the rate of CR of neck nodes was 49%. Fifty-one percent had less than a complete response of neck nodes after IC and required planned early neck dissection. There were no significant differences in patterns of recurrence, complications, interval time to start of radiation, recurrence, or survival rates between the CR and less than CR groups. These data suggest that planned early neck dissection for patients with less than CR in the neck after IC is not detrimental with respect to neck relapse or overall survival. We believe that planned early neck dissection can be safely incorporated into future organ preservation treatment protocols for patients with advanced head and neck carcinoma.

Original languageEnglish
Pages (from-to)1129-1137
Number of pages9
JournalLaryngoscope
Volume107
Issue number8
DOIs
StatePublished - Aug 1 1997
Externally publishedYes

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Induction Chemotherapy
Neck Dissection
Neck
Organ Preservation
Radiation
Recurrence
Head
Squamous Cell Carcinoma
Survival
Clinical Protocols
Radiotherapy
Survival Rate
Neoplasm Metastasis
Carcinoma
Drug Therapy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Planned early neck dissection before radiation for persistent neck nodes after induction chemotherapy. / Thomas, Giovana; Greenberg, Jason; Wu, Kuo Tsung; Moe, Kris; Esclamado, Ramon; Bradford, Carol; Carroll, William; Eisbruch, Avraham; Urba, Susan; Wolf, Gregory T.

In: Laryngoscope, Vol. 107, No. 8, 01.08.1997, p. 1129-1137.

Research output: Contribution to journalArticle

Thomas, G, Greenberg, J, Wu, KT, Moe, K, Esclamado, R, Bradford, C, Carroll, W, Eisbruch, A, Urba, S & Wolf, GT 1997, 'Planned early neck dissection before radiation for persistent neck nodes after induction chemotherapy', Laryngoscope, vol. 107, no. 8, pp. 1129-1137. https://doi.org/10.1097/00005537-199708000-00023
Thomas, Giovana ; Greenberg, Jason ; Wu, Kuo Tsung ; Moe, Kris ; Esclamado, Ramon ; Bradford, Carol ; Carroll, William ; Eisbruch, Avraham ; Urba, Susan ; Wolf, Gregory T. / Planned early neck dissection before radiation for persistent neck nodes after induction chemotherapy. In: Laryngoscope. 1997 ; Vol. 107, No. 8. pp. 1129-1137.
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