Incidence of subclinical nodal disease at the time of salvage surgery for locally recurrent head and neck cancer initially treated with definitive radiation therapy.
OBJECTIVE
To estimate the incidence of subclinical nodal disease at the time of isolated local recurrence (LR) after chemoradiotherapy for an initially staged N0 head and neck squamous cell carcinoma.


METHODS
We retrospectively reviewed 44 patients who underwent salvage surgery with or without elective neck dissection (END) for an isolated LR between 1997 and 2010. The incidence of subclinical nodal disease was determined from the pathology reports and from clinical neck failures.


RESULTS
Thirty patients received END. The overall incidence of subclinical nodal disease in patients with dissected necks was 10% (3/30 patients). The rate of regional control for the 14 observed necks was 100%. Three-year local control and overall survival rates for the END and non-END cohorts were 71% versus 73% (P=0.80) and 55% versus 64%, respectively (P=0.40).


CONCLUSIONS
The risk of subclinical nodal disease is low for patients with an isolated LR after chemoradiotherapy.
*Department of Radiation Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey Departments of †Radiation Oncology ‡Otolaryngology/Head & Neck Surgery §Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
Eda
E
Yirmibesoglu
David
D
Fried
Carol
C
Shores
Julian
J
Rosenman
Mark
M
Weissler
Trevor
T
Hackman
Bhishamjit S
BS
Chera
D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D009657:North Carolina / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate