title: Role of neck dissection following concurrent chemoradiation for advanced head and neck carcinoma.
abstract: 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.
authors.affiliation: 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.
authors.forename: Véronique-Isabelle
authors.initials: VI
authors.lastname: Forest
authors.forename: Phuc Félix
authors.initials: PF
authors.lastname: Nguyen-Tan
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tabet
authors.forename: Marie-Jo
authors.initials: MJ
authors.lastname: Olivier
authors.forename: Daniel
authors.initials: D
authors.lastname: Larochelle
authors.forename: Bernard
authors.initials: B
authors.lastname: Fortin
authors.forename: Michel
authors.initials: M
authors.lastname: Gélinas
authors.forename: Denis
authors.initials: D
authors.lastname: Soulières
authors.forename: Danielle
authors.initials: D
authors.lastname: Charpentier
authors.forename: Louis
authors.initials: L
authors.lastname: Guertin
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D017671:Platinum Compounds