Planned neck dissection before combined chemoradiation in organ preservation protocol for N2-N3 of supraglottic or hypopharyngeal carcinoma.
OBJECTIVE
To investigate the clinical therapeutic outcomes and neck node control of a pretreatment neck dissection in the chemoradiation protocol of organ preservation for N2-N3 of supraglottic and hypopharyngeal carcinoma.


METHODS
Forty-six patients (group A) with untreated N2 or N3 squamous cell carcinoma of the supraglottis or hypopharynx underwent pretreatment neck dissection in a chemoradiation protocol, while 39 patients (group B) did not undergo pretreatment neck dissection in a chemoradiation protocol. Salvage surgeries were used for local or cervical node residual tumor or recurrence after chemoradiotherapy.


RESULTS
In group A, the mean time between neck dissection and chemoradiation was 21 days (range 15-29). Only 3 patients (6.5%) experienced wound complications. A 'boost' of radiation of 12 Gy was delivered after 33 neck dissections (64.8%) in patients with extracapsular spread. The Kaplan-Meier 5-year overall survival rate was 42.5%. The 5-year overall survival rate and disease-specific survival rate in group A was 42.5 and 46.4%. The rate of neck node control in group A was better than that in group B (86.3 vs. 65.9%, p = 0.02).


CONCLUSIONS
Pretreatment neck dissection in a chemoradiation protocol for supraglottic or hypopharyngeal carcinoma showed low complication rates, no delay for radiation, optimal radiation doses, and a high nodal disease control.
Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, Guangzhou, PR China.
Xue-Kui
XK
Liu
Quan
Q
Li
Quan
Q
Zhang
Yong
Y
Su
Yan-Xia
YX
Shi
Hao
H
Li
Zong-Yuan
ZY
Zeng
Zhu-Ming
ZM
Guo
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D037981:Neck Dissection / Q000379:methods* / Q000401:mortality; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D016879:Salvage Therapy / Q000379:methods / Q000401:mortality; D000077195:Squamous Cell Carcinoma of Head and Neck