Planned neck dissection before combined chemoradiation in organ preservation protocol for N2-N3 of supraglottic or hypopharyngeal carcinoma.

Abstract

OBJECTIVE:

To investigate the clinical therapeutic outcomes and neck node control of a pretreatment neck dissection in the chemoradiation protocol of organ preservation for N2-N3 of supraglottic and hypopharyngeal carcinoma.

METHODS:

Forty-six patients (group A) with untreated N2 or N3 squamous cell carcinoma of the supraglottis or hypopharynx underwent pretreatment neck dissection in a chemoradiation protocol, while 39 patients (group B) did not undergo pretreatment neck dissection in a chemoradiation protocol. Salvage surgeries were used for local or cervical node residual tumor or recurrence after chemoradiotherapy.

RESULTS:

In group A, the mean time between neck dissection and chemoradiation was 21 days (range 15-29). Only 3 patients (6.5%) experienced wound complications. A 'boost' of radiation of 12 Gy was delivered after 33 neck dissections (64.8%) in patients with extracapsular spread. The Kaplan-Meier 5-year overall survival rate was 42.5%. The 5-year overall survival rate and disease-specific survival rate in group A was 42.5 and 46.4%. The rate of neck node control in group A was better than that in group B (86.3 vs. 65.9%, p = 0.02).

CONCLUSIONS:

Pretreatment neck dissection in a chemoradiation protocol for supraglottic or hypopharyngeal carcinoma showed low complication rates, no delay for radiation, optimal radiation doses, and a high nodal disease control.

• Authors: Xue-Kui Liu, Quan Li, Quan Zhang, Yong Su, Yan-Xia Shi, Hao Li, Zong-Yuan Zeng, Zhu-Ming Guo
• Journal: ORL; journal for oto-rhino-laryngology and its related specialties (ORL J Otorhinolaryngol Relat Spec) Vol. 74 Issue 2 Pg. 64-9 ( 2012) ISSN: 1423-0275 [Electronic] Switzerland
• PMID: 22327028 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 S. Karger AG, Basel.

Topics

• Adult
• Aged
• Carcinoma, Squamous Cell (mortality, secondary, surgery, therapy)
• Chemoradiotherapy (methods, mortality)
• Female
• Follow-Up Studies
• Glottis (surgery)
• Head and Neck Neoplasms (mortality, secondary, surgery, therapy)
• Humans
• Hypopharyngeal Neoplasms (mortality, pathology, surgery, therapy)
• Kaplan-Meier Estimate
• Lymphatic Metastasis
• Male
• Middle Aged
• Neck (surgery)
• Neck Dissection (methods, mortality)
• Neoplasm Recurrence, Local (mortality)
• Postoperative Complications (mortality)
• Salvage Therapy (methods, mortality)
• Squamous Cell Carcinoma of Head and Neck