title: (Chemo)radiotherapy after laser microsurgery and selective neck dissection for pN2 head and neck cancer.
abstract: This study analyzed the efficacy of transoral laser microsurgery and postoperative (chemo) radiotherapy (CRT) for head and neck squamous cell carcinoma. Between 1987 and 2007, 318 patients with pN2 neck disease were included. Seventy-three patients received laser resection and neck dissection alone, 154 postoperative radiotherapy, and 91 postoperative (C)RT. Mean follow-up was 58.2 ± 51.2 months, and locoregional control was significantly better after postoperative (C)RT (surgery alone: 42 %, radiotherapy: 57 %, CRT: 59 %; p < 0.01). Postoperative (C)RT did not have a significant impact on disease-specific survival (DSS) (surgery alone: 55 %, radiotherapy alone: 60 %, CRT: 64 %; p = 0.36). Fifty-seven patients (17.92 %) developed distant metastases, and 39 patients (12.26 %) presented with secondary malignancies, with no significant differences found between the treatment groups. Postoperative (C)RT significantly improved locoregional control, but had no significant effect on DSS because of high rates of secondary malignancies and distant metastases. Reduced radicality in combination with an effective screening might improve prognosis and quality of life of these patients.
authors: Department of Radiotherapy and Radiation Oncology, University of Göttingen, Göttingen, Germany.
authors: Hendrik Andreas
authors: HA
authors: Wolff
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
authors: Friedrich
authors: F
authors: Ihler
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
authors: Nina
authors: N
authors: Zeller
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
authors: Christian
authors: C
authors: Welz
authors: Department of Medical Statistics, University of Göttingen, Göttingen, Germany.
authors: Klaus
authors: K
authors: Jung
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. martin.canis@med.uni-goettingen.de.
authors: Martin
authors: M
authors: Canis
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
authors: Wolfgang
authors: W
authors: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: (Chemo)radiotherapy; HNSCC; Selective neck dissection; Transoral laser microsurgery; pN2