title: Prognostic significance of extracapsular spread in isolated neck recurrences in head and neck squamous cell carcinoma patients.
abstract: Few studies have analyzed the appearance of extracapsular spread (ECS) in salvage neck dissections carried out after regional recurrence of the disease. The aim of our study was to evaluate the frequency of ECS in patients with an isolated regional recurrence treated with a salvage neck dissection, and to assess the influence of ECS on prognosis. We conducted a retrospective study of 123 patients treated with a salvage neck dissection. Eighty-two patients (66.7 %) had nodes with ECS. Five-year salvage-specific survival for patients without ECS was 77.2 %, whereas for patients with ECS it was 32.0 % (P = 0.0001). According to the results of a multivariate analysis, the presence of ECS in the salvage neck dissection was the only variable significantly related to the salvage-specific survival. Sixty-six percent of the patients with nodes with ECS had adjuvant treatment with radiotherapy or chemoradiotherapy. Five-year salvage-specific survival for patients with ECS who had not received adjuvant treatment (n = 26) was 15.2 %, whereas for patients treated with adjuvant radiotherapy (n = 39) or chemotherapy (n = 17), 5-year salvage-specific survival was 36.4 and 47.1 %, respectively. Patients with ECS could benefit from adjuvant treatment with radiotherapy or chemoradiotherapy.
authors: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain. xleon@santpau.cat.|Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain. xleon@santpau.cat.
authors: Xavier
authors: X
authors: León
authors: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain.
authors: Antoni
authors: A
authors: Rigó
authors: Radiation Oncology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Nuria
authors: N
authors: Farré
authors: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain.
authors: Montserrat
authors: M
authors: López
authors: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain.
authors: Jacinto
authors: J
authors: García
authors: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain.
authors: Julia
authors: J
authors: de Juan
authors: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain.
authors: Miquel
authors: M
authors: Quer
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D059248:Chemoradiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection / Q000379:methods; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
keywords: Extracapsular spread; Head and neck squamous cell carcinoma; Neck recurrence; Prognosis; Salvage neck dissection