title: Management of advanced nodal disease in patients treated with primary chemoradiotherapy.
abstract: OBJECTIVE
  The management of advanced nodal disease in patients treated with chemoradiotherapy has been a controversial topic for many years. New data have recently been reported, including the results of a multicentre randomized trial making this review timely.
  
  
  RESULTS
  The PET-NECK trial showed that PET-computer tomography (CT) surveillance is as effective as planned neck dissection in terms of overall survival, but results in much fewer neck dissections, less complications and is more cost effective. Cost-effectiveness data from a single centre study demonstrated that strategies that include PET-CT were more effective than CT-alone-guided strategies.
  
  
  CONCLUSIONS
  There is now level 1 evidence to support image-guided surveillance strategies as the standard of care for advanced nodal disease in patients treated with primary chemoradiotherapy.
authors.affiliation: aInstitute of Head and Neck Studies and Education, University of Birmingham, Birmingham bPaul Strickland Scanner Centre, Mount Vernon Hospital, Northwood cWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
authors.forename: Hisham
authors.initials: H
authors.lastname: Mehanna
authors.forename: Wai Lup
authors.initials: WL
authors.lastname: Wong
authors.forename: Janet
authors.initials: J
authors.lastname: Dunn
mesh_terms: D059248:Chemoradiotherapy; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D015337:Multicenter Studies as Topic; D037981:Neck Dissection / Q000379:methods*; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D049268:Positron-Emission Tomography / Q000379:methods; D016032:Randomized Controlled Trials as Topic