Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-29T06:28:47.919Z Has data issue: false hasContentIssue false

Postoperative radiotherapy for head and neck cancer with single positive node

Published online by Cambridge University Press:  25 February 2010

Federico L. Ampil
Affiliation:
Department of Radiology
Gloria Caldito
Affiliation:
Department of Biometry
Cherie-Ann Nathan
Affiliation:
Department of Otolaryngology Head and Neck Surgery
Ghali Ghali
Affiliation:
Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Centre and Feist-Weiller Cancer Centre, Shreveport, Louisiana
Roxana Baluna
Affiliation:
Department of Radiology
Stephen Jones
Affiliation:
Department of Radiology

Abstract

The essential need for postoperative irradiation in people with carcinoma of the upper aerodigestive tract and limited metastatic nodal spread is controversial. An experience with postoperative radiotherapy in head and neck cancer (HNC) patients with one histologically positive cervical node is presented. Between 1976 and 2000, 37 individuals with confirmed metastatic disease in a single neck node underwent postoperative radiotherapy. The median follow-up period was 24 months. Among the 35 evaluable patients, the observed failure rates at the primary site, neck and distant location were 11%, 15% and 6%, respectively. The overall 5-year relapse-free survival rate was 60%. The relapse-free survival rate at 5 years was 86% in individuals who did not have additional histopathological risk factors and 55% in those patients who did (p = 0.46). The precise role of postoperative radiotherapy in people with HNC and documented metastasis in a single cervical lymph node remains to be defined including the identification of select individuals who may truly benefit from the combined therapy program.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jones, AS. Prognosis in mouth cancer: tumour factors. Eur J Cancer, B, Oral Oncol 1994; 30B: 815.CrossRefGoogle ScholarPubMed
Olsen, KD, Caruso, M, Foote, RL, Stanley, RJ, Lewis, JE, Buskirk, SJ, Frassica, DA, DeSanto, LW, O’Fallon, WM, Hoverman, VR. Primary head and neck cancer. Histopathologic predictors of recurrence after neck dissection in patients with lymph node involvement. Arch Otolaryngol Head Neck Surg 1994; 120: 13701374.CrossRefGoogle ScholarPubMed
Lim, YC, Choi, EC. Surgery alone for squamous cell carcinoma of the oral cavity: survival rates, recurrence patterns, and salvage treatment. Acta Otolaryngol 2008; 128: 11321137.CrossRefGoogle ScholarPubMed
Gourin, CG, Conger, BT, Porubsky, ES, Sheils, WC, Bilodeau, PA, Coleman, TA. The effect of occult nodal metastases on survival and regional control in patients with head and neck squamous cell carcinoma. Laryngoscope 2008; 118: 11911194.CrossRefGoogle ScholarPubMed
Brown, JS, Blackburn, TK, Woolgar, JA, Lowe, D, Errington, RD, Vaughan, ED, Rogers, SN. A comparison of outcomes for patients with oral squamous cell carcinoma at intermediate risk of recurrence treated by surgery alone or with post-operative radiotherapy. Oral Oncol 2007; 43: 764773.CrossRefGoogle ScholarPubMed
Cooper, JS, Pajak, TF, Forastiere, A, Jacobs, J, Fu, KK, Ang, KK, Laramore, GE, Al-Sarraf, M. Precisely defining high-risk operable head and neck tumors based on RTOG #85-03 and #88-24: targets for postoperative radiochemotherapy? Head Neck 1998; 20: 588594.3.0.CO;2-F>CrossRefGoogle Scholar
DeSanto, LW, Beahrs, OH, Holt, JJ, O'Fallon, WM. Neck dissection and combined therapy. Study of effectiveness. Arch Otolaryngol 1985; 111: 366370.CrossRefGoogle ScholarPubMed
Kalnins, IK, Leonard, AG, Sako, K, Razack, MS, Shedd, DP. Correlation between prognosis and degree of lymph node involvement in carcinoma of the oral cavity. Am J Surg 1977; 134: 450454.CrossRefGoogle ScholarPubMed
Mamelle, G, Pampurik, J, Luboinski, B, Lancar, R, Lusinchi, A, Bosq, J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg 1994; 168: 494498.CrossRefGoogle ScholarPubMed
Shingaki, S, Takada, M, Sasai, K, Bibi, R, Kobayashi, T, Nomura, T, Saito, C. Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 2003; 185: 278284.CrossRefGoogle ScholarPubMed
Byers, RM. Modified neck dissection. A study of 967 cases from 1970 to 1980. Am J Surg 1985; 150: 414421.CrossRefGoogle ScholarPubMed
O'Brien, CJ, Smith, JW, Soong, SJ, Urist, MM, Maddox, WA. Neck dissection with and without radiotherapy: prognostic factors, patterns of recurrence, and survival. Am J Surg 1986; 152: 456463.CrossRefGoogle ScholarPubMed