Premium
Treatment of the N0 neck during salvage surgery after radiotherapy of head and neck squamous cell carcinoma
Author(s) -
Temam Stephane,
Koka Venkata,
Mamelle Gérard,
Julieron Morbize,
Carmantrant Romain,
Marandas Patrick,
Janot Francois,
Bourhis Jean,
Luboinski Bernard
Publication year - 2005
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20234
Subject(s) - medicine , neck dissection , radiation therapy , surgery , larynx , salvage therapy , occult , salvage surgery , head and neck squamous cell carcinoma , metastasis , lymph node , primary tumor , carcinoma , radiology , head and neck cancer , cancer , chemotherapy , alternative medicine , pathology
Background. The morbidity and mortality rates of salvage surgery in patients with local recurrence of head and neck squamous cell carcinoma (HNSCC) after radiotherapy are high. The aim of this study was to determine the rate of occult neck node metastasis and the surgical morbidity of patients after salvage surgery for local relapse after definitive radiotherapy. Methods. Thirty patients who underwent salvage surgery with a simultaneous neck node dissection for a local relapse after definitive radiotherapy for HNSCC between 1992 and 2000 were included in this study. The primary tumor sites were oral cavity in six patients, oropharynx in 17, supraglottic larynx in three, and hypopharynx in four. Initially, seven patients had T2 disease, eight had T3, and 15 had T4. Results. Twelve patients (40%) experienced postoperative complications, including two deaths. There was no cervical lymph node metastasis (pN0) in 29 of the 30 patients. Fifteen patients (50%) had a recurrence after salvage surgery, including 11 new local recurrences and four patients with distant metastasis. Conclusions. The risk of neck node metastasis during salvage surgery for local recurrence in patients treated initially with radiation for N0 HNSCC is low. Neck dissection should be performed in only limited area, depending on the surgical procedure used for tumor resection. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005