Lymph node positive head and neck carcinoma after curative radiochemotherapy: A long lasting debate on elective post-therapeutic neck dissections comes to a conclusion |
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| Authors: | RM Hermann H Christiansen RM Rödel |
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| Institution: | 1. Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany;2. Zentrum für Strahlentherapie und Radioonkologie, Mozartstr. 30, Westerstede, Germany;3. Abteilung Hals-Nasen-Ohrenheilkunde, Universitätsmedizin, Robert-Koch-Str. 40, Göttingen, Germany;1. Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota;2. University of Minnesota Cytogenetics, Laboratory Medicine and Pathology, Minneapolis, Minnesota;1. Thoracic Division, Medical Oncology Department, European Institute of Oncology, Milan, Italy;2. Division of Pathology, European Institute of Oncology, Milan, Italy;3. Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy;1. Ultrasound and Elasticity Imaging Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA;2. Department of Dental Medicine, Columbia University Medical Center, New York, NY, USA;3. Department of Radiology, Columbia University Medical Center, New York, NY, USA;1. Service d’anatomie et cytologie pathologiques, hôpital Saint-Antoine, GH HUEP, AP–HP, 184, rue du Faubourg-Saint-Antoine, 75582 Paris cedex 12, France;2. Faculté de Médecine Pierre et Marie Curie, 75571 Paris cedex 12, France;1. Department of Obstetrics and Gynecology, University of Tuebingen, Tuebingen, Germany;2. Department of Pathology, University of Tuebingen, Tuebingen, Germany;3. Erbe Elektromedizin GmbH, Tuebingen, Germany |
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| Abstract: | There has been a long lasting debate, whether planned neck dissections after curative radio(chemo)therapy for locally advanced head and neck squamous cell carcinomas offer some benefit in tumor control or survival. We did a thorough literature research on that topic. The results of several recently published studies are described, summarized, and reviewed. Patients with residual disease in clinical or radiographic examinations (CT or MRI scans) up to 3 months after completion of radiochemotherapy profit from neck dissections. In patients with an initial or delayed clinical complete remission after completion of radiochemotherapy, a neck dissection can be safely omitted. In conclusion, there is no longer evidence for a benefit of prophylactic post-radiochemotherapy neck dissections, but strong evidence for a therapeutic post-radiochemotherapy neck dissection in this group of patients. |
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| Keywords: | Head and neck squamous cell carcinoma Radiochemotherapy Neck dissection Tumor response Carcinome épidermoïde des voies aérodigestives supérieures Chimioradiothérapie Curage ganglionnaire Réponse pathologique |
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