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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Prendes, Brandon L. Aubin-Pouliot, Annick Egbert, Nitin Ryan, William R. |
| Description | Country affiliation: United States Author Affiliation: Prendes BL ( Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA bprendes@ohns.ucsf.edu.); Aubin-Pouliot A ( University of California-San Francisco, School of Medicine, San Francisco, California, USA.); Egbert N ( The Ohio State University College of Medicine, Columbus, Ohio, USA.); Ryan WR ( Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA.) |
| Abstract | OBJECTIVE: This study aimed to assess the rate of occult metastases in patients with head and neck mucosal squamous cell carcinoma who have undergone therapeutic neck radiation, and then develop primary site recurrence, without clinical evidence of recurrent neck disease. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care center. SUBJECTS AND METHODS: Head and neck mucosal squamous cell carcinoma patients with N+ necks treated with primary radiation who developed primary site recurrence with radiologically resolved neck lymphadenopathy, treated with salvage primary-site surgery with or without elective cervical lymphadenectomy (ECL). Main outcome measures were rate of occult nodal metastases, complication rates, and disease-free survival. RESULTS: Sixteen patients met inclusion criteria. Of 18 neck sides that underwent either ECL or observation for a mean follow-up of 26 months, 4 (22.2%) were found to have positive occult cervical metastases, all on the ipsilateral side of preradiation neck disease. Patients with advanced T-stage and/or free flap reconstruction were more likely to undergo cervical lymphadenectomy. Patients with persistent (as opposed to recurrent) primary site tumors had the highest rate of occult cervical metastases. CONCLUSION: The risk of occult nodal metastases of 22.2%, in this study, may be too high to justify routinely omitting elective cervical lymphadenectomy in this patient population. Lymphadenectomy should especially be considered in patients with persistent tumors, with advanced recurrent T-stage, and undergoing free flap reconstruction. |
| File Format | HTM / HTML |
| ISSN | 01945998 |
| Issue Number | 3 |
| Volume Number | 151 |
| e-ISSN | 10976817 |
| Journal | Otolaryngology -- Head and Neck Surgery |
| Language | English |
| Publisher | SAGE Publications |
| Publisher Date | 2014-09-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Lymph Node Excision Comparative Study Age Factors Humans Middle Aged Salvage Therapy Male Head And Neck Neoplasms Journal Article Surgery Adult Female Retrospective Studies Secondary Risk Assessment Neoplasm Invasiveness Mortality Neoplasm Recurrence, Local Discipline Otolaryngology Lymphatic Metastasis Radiotherapy Lymph Nodes Carcinoma, Squamous Cell Disease-free Survival Pathology Sex Factors Survival Analysis Aged Neoplasm Staging Elective Surgical Procedures Methods Cohort Studies Neck Dissection |
| Content Type | Text |
| Resource Type | Article |
| Subject | Otorhinolaryngology Surgery |
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