title: Lymph node positive head and neck carcinoma after curative radiochemotherapy: a long lasting debate on elective post-therapeutic neck dissections comes to a conclusion.
abstract: There has been a long lasting debate, whether planned neck dissections after curative radio(chemo)therapy for locally advanced head and neck squamous cell carcinomas offer some benefit in tumor control or survival. We did a thorough literature research on that topic. The results of several recently published studies are described, summarized, and reviewed. Patients with residual disease in clinical or radiographic examinations (CT or MRI scans) up to 3 months after completion of radiochemotherapy profit from neck dissections. In patients with an initial or delayed clinical complete remission after completion of radiochemotherapy, a neck dissection can be safely omitted. In conclusion, there is no longer evidence for a benefit of prophylactic post-radiochemotherapy neck dissections, but strong evidence for a therapeutic post-radiochemotherapy neck dissection in this group of patients.
authors.affiliation: Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str 1, 30625 Hannover, Germany.
authors.forename: R M
authors.initials: RM
authors.lastname: Hermann
authors.forename: H
authors.initials: H
authors.lastname: Christiansen
authors.forename: R M
authors.initials: RM
authors.lastname: Rödel
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D017558:Elective Surgical Procedures; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D064847:Multimodal Imaging; D037981:Neck Dissection / Q000379:methods; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D018579:Patient Selection; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil
keywords: Carcinome épidermoïde des voies aérodigestives supérieures; Chimioradiothérapie; Curage ganglionnaire; Head and neck squamous cell carcinoma; Neck dissection; Radiochemotherapy; Réponse pathologique; Tumor response