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European Archives of Oto-Rhino-Laryngology

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28-10-2023 | Neck Dissection | Head and Neck

Results of salvage neck dissection after chemoradiation in locally advanced head and neck squamous cell carcinoma

Authors: L. López, P. García-Cabo, J. L. Llorente, F. López, J. P. Rodrigo

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2024

Abstract

Purpose

Salvage surgery is mandatory when regional persistence/recurrence after chemoradiation. The aim of this study is to describe the outcomes of salvage surgery.

Methods

A retrospective study was conducted in patients with locally advanced head and neck squamous cell carcinoma that were primarily treated with chemorradiation and underwent salvage neck dissection (ND) with suspected recurrent/persistent nodal disease. All patients had a response evaluation at 12 weeks through clinical examination and computed tomography-positron emission tomography. Decision for ND was taken in case of suspected persistence or if there was suspicion of recurrence, histologically confirmed.

Results

There were 40 patients included. 32/40 (80%) ND were done because of confirmed/suspected persistence and 8/40 (20%) were done because of recurrences. Persistence was confirmed histologically in 14/32 (43.8%) cases and recurrence in 6/8 (75%) cases. Median survival from diagnosis was 39 months (95% CI 28.162–49.838). Significant differences were observed between patients who had viable tumour cells in the sample and those who did not, but the differences were only significant when only deaths due to tumour progression were considered (p = 0.014). 14/32 (43.8%) patients with suspected or confirmed persistence developed a recurrence after the ND and 3/8 (37.5%) patients with suspected or confirmed recurrence developed a new recurrence. New recurrences were more frequent in cases that had viable tumor in the specimen.

Conclusions

Patients with nodal persistence/recurrence have a poor prognosis, even after salvage surgery. However, in a substantial number of patients the disease is controlled after ND, so it should be offer to these patients.

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Title: Results of salvage neck dissection after chemoradiation in locally advanced head and neck squamous cell carcinoma
Authors: L. López
P. García-Cabo
J. L. Llorente
F. López
J. P. Rodrigo
Publication date: 28-10-2023
Publisher: Springer Berlin Heidelberg
Keywords: Neck Dissection
Radiotherapy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2024
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08315-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Results of salvage neck dissection after chemoradiation in locally advanced head and neck squamous cell carcinoma

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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