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The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas

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Title: The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas
Authors: Sakashita, Tomohiro Browse this author →KAKEN DB
Homma, Akihiro Browse this author →KAKEN DB
Hayashi, Ryuichi Browse this author
Kawabata, Kazuyoshi Browse this author
Yoshino, Kunitoshi Browse this author
Iwae, Shigemichi Browse this author
Hasegawa, Yasuhisa Browse this author
Nibu, Kenichi Browse this author
Kato, Takakuni Browse this author
Shiga, Kiyoto Browse this author
Matsuura, Kazuto Browse this author
Monden, Nobuya Browse this author
Fujii, Masato Browse this author
Keywords: Regional recurrence
Regional control
Planned neck dissection
Salvage neck dissection
Issue Date: Jul-2014
Publisher: Elsevier
Journal Title: Oral Oncology
Volume: 50
Issue: 7
Start Page: 657
End Page: 661
Publisher DOI: 10.1016/j.oraloncology.2014.03.003
PMID: 24726547
Abstract: Background: The current study sought to assess the role of initial neck dissection (ND) for patients with node-positive oropharyngeal squamous cell carcinomas (OPSCC). Methods: The data for 202 patients with previously untreated node-positive OPSCC were gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group. These patients were categorized into two groups, consisting of the initial ND group and the wait-and-see group, according to treatment policy. Results: Regional recurrence was observed in 17 of 93 patients undergoing initial ND, whereas, recurrent or persistent diseases were observed in 40 of 109 patients who did not undergo initial ND. The 4-year overall survival rates (OS) for the wait-and-see group and initial ND groups were 74.0% and 78.7%, respectively, and the 4-year regional control rates (RC) for each group were 77.6% and 84.9%. There were no significant differences in either OS or RC (p = 0.3440 and p = 0.2382, respectively). However, for patients with N3 disease, the 4-year OS of the initial ND group (100%) was favorable. For patients with N2a disease, the 4-year RC of the initial ND group was higher than that of the wait-and-see group statistically (100% vs 62.5%, p = 0.0156). Conclusions: The role of initial ND was limited in patients with node-positive OPSCC. The treatment strategy not involving initial ND is considered feasible and acceptable when nodal evaluation after definitive radiotherapy or chemoradiotherapy is applied adequately. However, it is possible that initial ND improves outcomes in patients with resectable large-volume nodal disease. (C) 2014 Elsevier Ltd. All rights reserved.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 坂下 智博

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