title: Observation versus neck dissection for positron-emission tomography-negative lymphadenopathy after chemoradiotherapy.
abstract: OBJECTIVE
  To analyze outcomes among patients with residual positron-emission tomography (PET)-negative lymphadenopathy after chemoradiotherapy for head and neck cancer based on whether or not they underwent neck dissection.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Fifty-five patients with stage III/IV squamous cell carcinoma of the head and neck were identified with residual PET-negative lymphadenopathy based on standardized uptake value of <3. All patients had been treated with chemoradiotherapy to a median dose of 70 Gy (range, 60-4 Gy).
  
  
  RESULTS
  With a median follow-up of 30 months (range, 6-67 months), the 3-year overall survival (85% vs. 81%, P = .57), progression-free survival (88% vs. 88%, P = .42), and local-regional control (96% vs. 100%, P = .68), did not differ between patients treated by neck dissection or observation.
  
  
  CONCLUSIONS
  Omission of neck dissection appears to be reasonable for patients with residual lymphadenopathy but negative PET after chemoradiotherapy for head and neck cancer.
  
  
  METHODS
  4.
authors.affiliation: Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, California, U.S.A.
authors.forename: Behnood
authors.initials: B
authors.lastname: Khodayari
authors.forename: Megan E
authors.initials: ME
authors.lastname: Daly
authors.forename: Matthew
authors.initials: M
authors.lastname: Bobinski
authors.forename: D Gregory
authors.initials: DG
authors.lastname: Farwell
authors.forename: David K
authors.initials: DK
authors.lastname: Shelton
authors.forename: Allen M
authors.initials: AM
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000556:secondary / Q000628:therapy*; D059248:Chemoradiotherapy; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000556:secondary / Q000628:therapy*; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000000981:diagnostic imaging* / Q000209:etiology; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
keywords: Chemoradiotherapy; cancer; lymphadenopathy; observation; positron-emission tomography