title: The role of neck dissection after radical chemoradiation for locally advanced head and neck cancer: should we move back?.
abstract: Until a few decades ago neck dissection (ND) was the standard surgical approach for node-positive tumours. Nowadays patients with locally advanced head and neck cancer can be treated with definitive chemoradiation (CRT), which includes the treatment of the neck; however, results on residual viable tumour after conservative treatment are heterogeneous and depend on initial node stage and primary treatment. Many authors accept adjuvant surgery in patients with N2-3 disease. Regardless of the results of upfront CRT, even if there is no evidence of lymph node metastases, when the risk for persistent positive neck nodes exceeds 15-20%, elective ND might be indicated. However, despite the diffusion of innovative technologies and therapies, there are controversies about both response evaluation and surgical management of initially involved neck nodes after definitive CRT and organ preservation treatment. In this paper we will analyse state of art of neck evaluation after CRT and discuss the role of ND.
authors.affiliation: Messina University, Messina, Italy. nerinadenaro@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Denaro
authors.forename: E G
authors.initials: EG
authors.lastname: Russi
authors.forename: G
authors.initials: G
authors.lastname: Numico
authors.forename: T
authors.initials: T
authors.lastname: Pazzaia
authors.forename: R
authors.initials: R
authors.lastname: Vitiello
authors.forename: M C
authors.initials: MC
authors.lastname: Merlano
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D059248:Chemoradiotherapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D018365:Neoplasm, Residual / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D011379:Prognosis