title: Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy.
abstract: OBJECTIVE
  The current study presents the long-term results from a study designed to evaluate a restaging positron emission tomography (PET) directed policy whereby neck dissections were omitted in all node positive head and neck squamous cell carcinoma (N+HNSCC) patients with PET-negative lymph nodes after definitive radiotherapy (RT), with or without chemotherapy.
  
  
  METHODS
  A post-therapy nodal response assessment with PET and computed tomography (CT) was performed in patients who achieved a complete response at the primary site after definitive radiotherapy. Patients with PET-negative lymph nodes were observed regardless of residual CT abnormalities.
  
  
  RESULTS
  One hundred and twelve patients, the majority of whom (83 patients, 74%) had oropharyngeal primaries, were treated on protocol. Median follow-up was 62months. Negative and positive predictive values for the restaging PET was 97.1% and 77.8% respectively, with only one patient who was PET-negative after treatment experiencing an isolated nodal relapse.
  
  
  CONCLUSIONS
  PET-guided management of the neck following organ preservation therapy effectively spares neck dissections in patients with N+HNSCC without compromising isolated nodal control or overall survival.
authors.affiliation: Skane University Hospital, Department of ORL-Head and Neck Surgery, Clinical Sciences, Lund University, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Sjövall
authors.affiliation: Princess Alexandra Hospital, Radiation Oncology, Brisbane, Queensland, Australia; Princess Alexandra Hospital, Department of Otolaryngology, Brisbane, Queensland, Australia. Electronic address: benjamin.chua@health.qld.gov.au.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chua
authors.affiliation: Princess Alexandra Hospital, Radiation Oncology, Brisbane, Queensland, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Pryor
authors.affiliation: Princess Alexandra Hospital, Radiation Oncology, Brisbane, Queensland, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Burmeister
authors.affiliation: Princess Alexandra Hospital, Radiation Oncology, Brisbane, Queensland, Australia; University of Queensland, St. Lucia, Queensland, Australia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Foote
authors.affiliation: Princess Alexandra Hospital, Department of Otolaryngology, Brisbane, Queensland, Australia; University of Queensland, St. Lucia, Queensland, Australia.
authors.forename: Benedict
authors.initials: B
authors.lastname: Panizza
authors.affiliation: Princess Alexandra Hospital, Radiation Oncology, Brisbane, Queensland, Australia; University of Queensland, St. Lucia, Queensland, Australia.
authors.forename: Bryan H
authors.initials: BH
authors.lastname: Burmeister
authors.affiliation: Princess Alexandra Hospital, Radiation Oncology, Brisbane, Queensland, Australia; University of Queensland, St. Lucia, Queensland, Australia.
authors.forename: Sandro V
authors.initials: SV
authors.lastname: Porceddu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Chemotherapy; Head and neck; Neck dissection; PET; Radiotherapy; Squamous cell carcinoma