Neck dissection followed by radiotherapy or chemoradiotherapy for small primary oropharynx carcinoma with cervical metastasis.
OBJECTIVE
A cohort of patients with small primary (T1-T2) squamous cell carcinoma of the oropharynx and advanced cervical nodal metastasis were treated with initial neck dissection(s) followed by definitive radiation therapy with or without chemotherapy. Our rationale for this algorithm and our results are examined.


METHODS
Retrospective chart review.


METHODS
Pathology records and medical records from 1996 to 2003 from the Johns Hopkins Hospital were examined for patients meeting the inclusion criteria.


RESULTS
Sixteen patients meeting the inclusion criteria were identified. Follow-up periods ranged from 6 to 75 months. Mean and median follow-up periods were 38 and 33 months, respectively. One (6.25%) patient developed a metastasis and was alive with disease at last follow-up. Fifteen (93.75%) patients were alive without evidence of disease at last follow-up. Overall survival was 100%. Disease free survival was 93.75%.


CONCLUSIONS
Initial neck dissection followed by primary radiation therapy to the primary site and neck with or without chemotherapy is an effective therapy for small primary oropharynx cancers with N2 or greater cervical metastases.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Ashok N
AN
Reddy
David W
DW
Eisele
Arlene A
AA
Forastiere
Ding J
DJ
Lee
William H
WH
Westra
Joseph A
JA
Califano
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors