Management of the clinically positive neck in organ preservation for advanced head and neck cancer

Paul Dagum, Harlan A. Pinto, James P. Newman, John P. Higgins, David J Terris, Don R. Goffinet, Willard E. Fee

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

BACKGROUND: To investigate clinicopathologic predictive criteria for the optimal management of neck metastases in patients with advanced head and neck cancers treated with combined chemoradiotherapy. METHODS: Prospective study, 48 patients. Mean length follow-up, 23 months. RESULTS: Neck stage predicted neck response to chemoradiotherapy; N3 necks showed more partial responses (P = 0.04), and N1 necks showed more complete responses (P = 0.12). Primary tumor site strongly predicted the pathologic response found on neck dissection in patients with a clinical partial response (cPR) following chemoradiotherapy. There was no difference in survival between patients with a clinical complete response (cCR) after chemoradiotherapy, and patients with a pathologic complete response (pCR) after neck dissection (P = 0.20); however, when grouped together, these patients survived longer than did patients with a pPR at neck dissection (P = 0.06). CONCLUSIONS: Clinical response to induction chemotherapy is a poor predictor of ultimate neck control. Induction chemotherapy followed by chemoradiotherapy, and planned neck dissection for patients with persistent cervical lymphadenopathy, provides good regional control.

Original languageEnglish (US)
Pages (from-to)448-452
Number of pages5
JournalAmerican Journal of Surgery
Volume176
Issue number5
DOIs
StatePublished - Nov 1 1998
Externally publishedYes

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Organ Preservation
Head and Neck Neoplasms
Neck
Chemoradiotherapy
Neck Dissection
Induction Chemotherapy
Prospective Studies
Neoplasm Metastasis
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Management of the clinically positive neck in organ preservation for advanced head and neck cancer. / Dagum, Paul; Pinto, Harlan A.; Newman, James P.; Higgins, John P.; Terris, David J; Goffinet, Don R.; Fee, Willard E.

In: American Journal of Surgery, Vol. 176, No. 5, 01.11.1998, p. 448-452.

Research output: Contribution to journalArticle

Dagum, Paul ; Pinto, Harlan A. ; Newman, James P. ; Higgins, John P. ; Terris, David J ; Goffinet, Don R. ; Fee, Willard E. / Management of the clinically positive neck in organ preservation for advanced head and neck cancer. In: American Journal of Surgery. 1998 ; Vol. 176, No. 5. pp. 448-452.
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