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

Sakashita, Tomohiro; Homma, Akihiro; Hayashi, Ryuichi; Kawabata, Kazuyoshi; Yoshino, Kunitoshi; Iwae, Shigemichi; Hasegawa, Yasuhisa; Nibu, Kenichi; Kato, Takakuni; Shiga, Kiyoto; Matsuura, Kazuto; Monden, Nobuya; Fujii, Masato

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

Sakashita, Tomohiro; Homma, Akihiro; Hayashi, Ryuichi et al.

Oral Oncology, 2014, 50(7), 657-661

Permalink : https://hdl.handle.net/2115/56762

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アクセス権	open access
URI	https://hdl.handle.net/2115/56762
タイトル	The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas
著者	Sakashita, Tomohiro ; Homma, Akihiro ; Hayashi, Ryuichi ; Kawabata, Kazuyoshi ; Yoshino, Kunitoshi ; Iwae, Shigemichi ; Hasegawa, Yasuhisa ; Nibu, Kenichi ; Kato, Takakuni ; Shiga, Kiyoto ; Matsuura, Kazuto ; Monden, Nobuya ; Fujii, Masato
e-Rad_Researcher 30455654 著者名 Sakashita, Tomohiro
e-Rad_Researcher 30312359 著者名 Homma, Akihiro
著者名 Hayashi, Ryuichi
著者名 Kawabata, Kazuyoshi
著者名 Yoshino, Kunitoshi
著者名 Iwae, Shigemichi
著者名 Hasegawa, Yasuhisa
著者名 Nibu, Kenichi
著者名 Kato, Takakuni
著者名 Shiga, Kiyoto
著者名 Matsuura, Kazuto
著者名 Monden, Nobuya
著者名 Fujii, Masato
言語	英語
キーワード	Regional recurrence
	Regional control
	Planned neck dissection
	Salvage neck dissection
	Chemoradiotherapy
発行日	2014-07
出版者	Elsevier
収録物名	Oral Oncology
巻(号)	50(7)
ページ	657-661
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	1368-8375
NCID	AA10846349
関連情報	PMID 24726547
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.oraloncology.2014.03.003