title: Isolated neck recurrence after definitive radiotherapy for node-positive head and neck cancer: salvage in the dissected or undissected neck.
abstract: BACKGROUND
  The role of salvage neck dissection for isolated regional recurrences after definitive radiotherapy (RT) is ill-defined.
  
  
  METHODS
  Five-hundred fifty patients were treated with RT for lymph node-positive head and neck cancer. RT consisted of a median dose of 74.4 Gy. Chemotherapy was administered in 133 patients (24%). Patients were followed for neck failure after planned neck dissection (n = 341) or observation (n = 209). Salvage therapy was offered to those with isolated neck recurrences.
  
  
  RESULTS
  There were 54 (10%) failures in the neck at a median 3.7 months after RT (range, 0 to 17 months). Thirteen patients had isolated recurrences after receiving definitive RT with (n = 11) or without (n = 2) neck dissection. Nine patients underwent attempted surgical salvage with or without re-irradiation and 4 were successfully salvaged without major complications.
  
  
  CONCLUSIONS
  Patients with neck failure after definitive therapy usually have poor outcomes, but salvage attempts may be successful in selected patients with an isolated neck recurrence.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Liauw
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amdur
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.forename: John W
authors.initials: JW
authors.lastname: Werning
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Villaret
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis