Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

Xavier León; Laura Pardo; Aina Sansa; Alejandro Fernández; Valle Camacho; Jacinto García; Montserrat López; Miquel Quer

doi:10.1002/hed.25390

Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

Xavier León, Laura Pardo, Aina Sansa, Alejandro Fernández, Valle Camacho, Jacinto García, Montserrat López, Miquel Quer

Department of Surgery

Research output: Contribution to journal › Article › Research

Abstract

© 2018 Wiley Periodicals, Inc. Background: The purpose of this study is to evaluate the prognostic significance of nodes with extracapsular spread (ECS) in patients treated with a planned neck dissection after chemoradiotherapy. Methods: We carried out a retrospective study of 109 cN+ patients who achieved a complete response in the primary location after chemoradiotherapy and treated with a planned neck dissection. Results: The 5-year disease-specific survival for patients without residual metastatic nodes in the neck dissection (pN0, n = 69) was 75.7% (95% CI: 64.4%-87.0%). For patients with metastatic nodes without ECS (pN+/ECS-negative, n = 17), the corresponding figure was 74.0% (95% CI: 48.2%-99.8%), and for patients with metastatic neck nodes with ECS (pN+/ECS-positive, n = 23) it was 8.7% (95% CI: 0.0%-24.3%) (P =.0001). Conclusion: The presence of ECS in the pathologic study of the planned neck dissections carried out after chemoradiotherapy in patients with human papillomavirus-negative (HPV-negative) head and neck squamous cell carcinoma (SCC) allows identification of a group of patients with a high risk of failure.

Original language	English
Pages (from-to)	2514-2520
Journal	Head and Neck
Volume	40
DOIs	https://doi.org/10.1002/hed.25390
Publication status	Published - 1 Nov 2018

Keywords

chemoradiotherapy
extracapsular spread
head and neck cancer
pathologic TNM
planned neck dissection

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@article{dfce95b2db6349f08a289cea24e5db85,

title = "Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy",

abstract = "{\textcopyright} 2018 Wiley Periodicals, Inc. Background: The purpose of this study is to evaluate the prognostic significance of nodes with extracapsular spread (ECS) in patients treated with a planned neck dissection after chemoradiotherapy. Methods: We carried out a retrospective study of 109 cN+ patients who achieved a complete response in the primary location after chemoradiotherapy and treated with a planned neck dissection. Results: The 5-year disease-specific survival for patients without residual metastatic nodes in the neck dissection (pN0, n = 69) was 75.7% (95% CI: 64.4%-87.0%). For patients with metastatic nodes without ECS (pN+/ECS-negative, n = 17), the corresponding figure was 74.0% (95% CI: 48.2%-99.8%), and for patients with metastatic neck nodes with ECS (pN+/ECS-positive, n = 23) it was 8.7% (95% CI: 0.0%-24.3%) (P =.0001). Conclusion: The presence of ECS in the pathologic study of the planned neck dissections carried out after chemoradiotherapy in patients with human papillomavirus-negative (HPV-negative) head and neck squamous cell carcinoma (SCC) allows identification of a group of patients with a high risk of failure.",

keywords = "chemoradiotherapy, extracapsular spread, head and neck cancer, pathologic TNM, planned neck dissection",

author = "Xavier Le{\'o}n and Laura Pardo and Aina Sansa and Alejandro Fern{\'a}ndez and Valle Camacho and Jacinto Garc{\'i}a and Montserrat L{\'o}pez and Miquel Quer",

year = "2018",

month = nov,

day = "1",

doi = "10.1002/hed.25390",

language = "English",

volume = "40",

pages = "2514--2520",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley and Sons Inc.",

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TY - JOUR

T1 - Prognostic role of extracapsular spread in planned neck dissection after chemoradiotherapy

AU - León, Xavier

AU - Pardo, Laura

AU - Sansa, Aina

AU - Fernández, Alejandro

AU - Camacho, Valle

AU - García, Jacinto

AU - López, Montserrat

AU - Quer, Miquel

PY - 2018/11/1

Y1 - 2018/11/1

N2 - © 2018 Wiley Periodicals, Inc. Background: The purpose of this study is to evaluate the prognostic significance of nodes with extracapsular spread (ECS) in patients treated with a planned neck dissection after chemoradiotherapy. Methods: We carried out a retrospective study of 109 cN+ patients who achieved a complete response in the primary location after chemoradiotherapy and treated with a planned neck dissection. Results: The 5-year disease-specific survival for patients without residual metastatic nodes in the neck dissection (pN0, n = 69) was 75.7% (95% CI: 64.4%-87.0%). For patients with metastatic nodes without ECS (pN+/ECS-negative, n = 17), the corresponding figure was 74.0% (95% CI: 48.2%-99.8%), and for patients with metastatic neck nodes with ECS (pN+/ECS-positive, n = 23) it was 8.7% (95% CI: 0.0%-24.3%) (P =.0001). Conclusion: The presence of ECS in the pathologic study of the planned neck dissections carried out after chemoradiotherapy in patients with human papillomavirus-negative (HPV-negative) head and neck squamous cell carcinoma (SCC) allows identification of a group of patients with a high risk of failure.

AB - © 2018 Wiley Periodicals, Inc. Background: The purpose of this study is to evaluate the prognostic significance of nodes with extracapsular spread (ECS) in patients treated with a planned neck dissection after chemoradiotherapy. Methods: We carried out a retrospective study of 109 cN+ patients who achieved a complete response in the primary location after chemoradiotherapy and treated with a planned neck dissection. Results: The 5-year disease-specific survival for patients without residual metastatic nodes in the neck dissection (pN0, n = 69) was 75.7% (95% CI: 64.4%-87.0%). For patients with metastatic nodes without ECS (pN+/ECS-negative, n = 17), the corresponding figure was 74.0% (95% CI: 48.2%-99.8%), and for patients with metastatic neck nodes with ECS (pN+/ECS-positive, n = 23) it was 8.7% (95% CI: 0.0%-24.3%) (P =.0001). Conclusion: The presence of ECS in the pathologic study of the planned neck dissections carried out after chemoradiotherapy in patients with human papillomavirus-negative (HPV-negative) head and neck squamous cell carcinoma (SCC) allows identification of a group of patients with a high risk of failure.

KW - chemoradiotherapy

KW - extracapsular spread

KW - head and neck cancer

KW - pathologic TNM

KW - planned neck dissection

U2 - 10.1002/hed.25390

DO - 10.1002/hed.25390

M3 - Article

C2 - 30307665

VL - 40

SP - 2514

EP - 2520

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

ER -