title: [Value of neck dissection before definitive radiation therapy for locoregionally advanced squamous cell carcinoma of the head and neck].
abstract: OBJECTIVE
  Optimal timing of neck dissection remains debated in the conservative management of patients with locoregionally advanced squamous cell carcinoma of the head and neck.
  
  
  METHODS
  The files of 63 patients with radiographic evidence of bulky or necrotic nodal metastases treated by up-front neck dissection and definitive radiotherapy between 2000 and 2012 at two institutions were retrospectively reviewed.
  
  
  RESULTS
  The primary site was oropharyngeal, hypopharyngeal or laryngeal in 63%, 21% and 13% cases, respectively. Overall, 83% of the tumours were staged pN2b or more. Extracapsular spread was found in 48 cases (77%). After a 48-month median follow-up, the 3-year locoregional control and overall survival were 88% and 68%, respectively. Only one isolated failure occurred in the dissected neck.
  
  
  CONCLUSIONS
  This combination therapy provides a good locoregional tumour control. It should be considered as an option in laryngeal, hypopharyngeal or oropharyngeal squamous cell carcinomas with bulky or necrotic nodal metastases at presentation.
authors.affiliation: Département de radiothérapie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; Inserm, UMR 1037, centre de recherche du cancer de Toulouse, 2, avenue Hubert-Curien, 31059 Toulouse cedex 9, France; Université Paul-Sabatier Toulouse III, 31100 Toulouse, France. Electronic address: modesto.anouchka@iuct-oncopole.fr.
authors.forename: A
authors.initials: A
authors.lastname: Modesto
authors.affiliation: Département de chirurgie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Sarini
authors.affiliation: Chirurgie cervicofaciale, 119, boulevard Abdelmoumen, Casablanca, Maroc.
authors.forename: A
authors.initials: A
authors.lastname: Benlyazid
authors.affiliation: Département de biostatistiques, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Ouali
authors.affiliation: Département de radiothérapie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Laprie
authors.affiliation: Département de radiothérapie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Graff
authors.affiliation: Département de chirurgie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Vergez
authors.affiliation: Département d'anatomie pathologique, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Uro-Coste
authors.affiliation: Département d'imagerie médicale, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: I
authors.initials: I
authors.lastname: Fauquet
authors.affiliation: Département d'oncologie médicale, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Delord
authors.affiliation: Département de radiothérapie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Rives
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D020360:Neoadjuvant Therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
keywords: Adénopathie; Cancer des VADS; Chimioradiothérapie; Curage ganglionnaire; Head and neck cancer; Neck dissection; Neck nodes; Radiation therapy; Radiothérapie