Open AccessNodal Disease in Post‐chemoradiotherapy Neck Dissection
Author(s) -
Ahsan Farhan,
Junor Elizabeth,
Ironside Janet,
Vernham Guy A.,
Ganly Ian,
Keh Siew M.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a124
Subject(s) - medicine , neck dissection , chemoradiotherapy , surgery , larynx , dissection (medical) , stage (stratigraphy) , primary tumor , pathological , radiation therapy , cancer , radiology , metastasis , biology , paleontology
Objective 1) Determine the rate of residual neck node disease in patients with squamous cell carcinoma of the larynx, hypopharynx, and oropharynx undergoing neck dissection post‐chemoradiation; and 2) Determine the impact on outcome. Method Design: Retrospective case series. Patients: Thirty‐three consecutive patients with residual neck disease following chemoradiotherapy for advanced stage laryngopharyngeal cancer were identified at a single institution between May 2003 and October 2007. Main outcome measure: Neck node pathological positivity, neck recurrence free survival, and disease specific survival. Results Thirty‐eight neck dissections were carried out in 33 patients (median ± STD age, 59 ± 7.8 years; 85% male). The oropharynx was the most common primary site (n = 27; 73%). The follow‐up duration ranged from 9 to 61 months. Pathologically, 39.4% (13/33) of patients had viable tumor cells identified in dissection specimen. Three patients (9%) developed primary site recurrence. One patient (3%) died from local/regional disease and 2 patients (6%) died from distant metastasis. There was no statistically significant ( P =. 37) increase in neck recurrence rate in the SND group when compared to the MRND and RND groups. Conclusion Viable tumor results in poorer outcome even after complete resection by neck dissection.