Role of neck dissection following concurrent chemoradiation for advanced head and neck carcinoma.
BACKGROUND
Our primary objective was to determine the role of neck dissection following concomitant chemoradiation (CRT) for advanced stage III-IV head and neck squamous cell carcinoma (HNSCC).


METHODS
One hundred eighty-four patients with HNSCC treated with CRT were included. One hundred twenty-three patients reached a regional complete response (CR) after CRT and no neck dissection was performed. Forty-five patients among the 58 who reached a regional partial response (PR) underwent a neck dissection.


RESULTS
Overall, regional CR rate after CRT was 68%. Patients who reached a regional CR (no neck dissection) had an overall neck recurrence rate of 5%. Patients with regional PR who underwent a neck dissection had a 7% neck recurrence rate.


CONCLUSIONS
Patients with regional CR not followed by a neck dissection have a low rate of neck recurrence. Systematic neck dissection is not mandatory for patients with nodes less than 6 cm reaching a regional CR. For patients with nodes larger than 6 cm, no firm recommendation can be given because of the small number of patients in this series. If the regional response is incomplete, cervical dissection is warranted.
Forest
Véronique-Isabelle
VI
Department of Otolaryngology-Head and Neck Surgery, Centre Hospitalier Universitaire de l'Université de Montréal, Pavillon B-Hôpital Notre-Dame, 1560, Sherbrooke East, Montreal, PQ, Canada H2L 4M1.
Nguyen-Tan
Phuc Félix
PF
Tabet
Jean-Claude
JC
Olivier
Marie-Jo
MJ
Larochelle
Daniel
D
Fortin
Bernard
B
Gélinas
Michel
M
Soulières
Denis
D
Charpentier
Danielle
D
Guertin
Louis
L
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D017671:Platinum Compounds / Q000008:administration & dosage; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D017671:Platinum Compounds