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2. Treatment of the neck in residual/recurrent disease after chemoradiotherapy for advanced primary laryngeal cancer

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Rodrigo, Juan P., López-Álvarez, Fernando, Medina, Jesús E., Silver, Carl E., Robbins, K. Thomas, Hamoir, Marc, Mäkitie, Antti, de Bree, Remco, Takes, Robert P., Golusinski, Pawel, Kowalski, Luiz P., Forastiere, Arlene A., Homma, Akihiro, Hanna, Ehab Y., Rinaldo, Alessandra, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Rodrigo, Juan P., López-Álvarez, Fernando, Medina, Jesús E., Silver, Carl E., Robbins, K. Thomas, Hamoir, Marc, Mäkitie, Antti, de Bree, Remco, Takes, Robert P., Golusinski, Pawel, Kowalski, Luiz P., Forastiere, Arlene A., Homma, Akihiro, Hanna, Ehab Y., Rinaldo, Alessandra, and Ferlito, Alfio

Published
2024

3. Review of Outcomes after Salvage Surgery for Recurrent Squamous Cell Carcinoma of the Head and Neck

Author

Hartl, Dana M., primary, Guerlain, Joanne, additional, Gorphe, Philippe, additional, Kapre, Madan, additional, Kapre Gupta, Neeti, additional, Saba, Nabil F., additional, Robbins, K. Thomas, additional, Ronen, Ohad, additional, Rodrigo, Juan P., additional, Strojan, Primož, additional, Mäkitie, Antti A., additional, Kowalski, Luiz P., additional, Shah, Jatin P., additional, and Ferlito, Alfio, additional

Published
2023
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4. Lymph Node Metastases from Non-Melanoma Skin Cancer of the Head and Neck

Author

Civantos, Francisco, primary, Helmen, Zachary M., additional, Bradley, Patrick J., additional, Coca-Pelaz, Andrés, additional, De Bree, Remco, additional, Guntinas-Lichius, Orlando, additional, Kowalski, Luiz P., additional, López, Fernando, additional, Mäkitie, Antti A., additional, Rinaldo, Alessandra, additional, Robbins, K. Thomas, additional, Rodrigo, Juan P., additional, Takes, Robert P., additional, and Ferlito, Alfio, additional

Published
2023
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5. Survival Outcomes in T3 Laryngeal Cancers: Primary Total Laryngectomy vs. Concurrent Chemoradiation or Radiation Therapy—A Meta-Analysis

Author

Rao, Karthik Nagaraja, primary, Pai, Prathamesh S., additional, Dange, Prajwal, additional, Kowalski, Luiz P., additional, Strojan, Primož, additional, Mäkitie, Antti A., additional, Guntinas-Lichius, Orlando, additional, Robbins, K. Thomas, additional, Rodrigo, Juan P., additional, Eisbruch, Avraham, additional, Takes, Robert P., additional, de Bree, Remco, additional, Coca-Pelaz, Andrés, additional, Piazza, Cesare, additional, Chiesa-Estomba, Carlos, additional, López, Fernando, additional, Saba, Nabil F., additional, Rinaldo, Alessandra, additional, and Ferlito, Alfio, additional

Published
2023
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6. Artificial Intelligence in Head and Neck Cancer: A Systematic Review of Systematic Reviews

Author

Maekitie, Antti AA, Alabi, Rasheed Omobolaji, Ng, Sweet Ping, Takes, Robert PP, Robbins, K Thomas, Ronen, Ohad, Shaha, Ashok RR, Bradley, Patrick JJ, Saba, Nabil FF, Nuyts, Sandra, Triantafyllou, Asterios, Piazza, Cesare, Rinaldo, Alessandra, and Ferlito, Alfio

Subjects
Artificial intelligence, Machine learning, Systematic review, Head and neck cancer
Abstract

INTRODUCTION: Several studies have emphasized the potential of artificial intelligence (AI) and its subfields, such as machine learning (ML), as emerging and feasible approaches to optimize patient care in oncology. As a result, clinicians and decision-makers are faced with a plethora of reviews regarding the state of the art of applications of AI for head and neck cancer (HNC) management. This article provides an analysis of systematic reviews on the current status, and of the limitations of the application of AI/ML as adjunctive decision-making tools in HNC management. METHODS: Electronic databases (PubMed, Medline via Ovid, Scopus, and Web of Science) were searched from inception until November 30, 2022. The study selection, searching and screening processes, inclusion, and exclusion criteria followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A risk of bias assessment was conducted using a tailored and modified version of the Assessment of Systematic Review (AMSTAR-2) tool and quality assessment using the Risk of Bias in Systematic Reviews (ROBIS) guidelines. RESULTS: Of the 137 search hits retrieved, 17 fulfilled the inclusion criteria. This analysis of systematic reviews revealed that the application of AI/ML as a decision aid in HNC management can be thematized as follows: (1) detection of precancerous and cancerous lesions within histopathologic slides; (2) prediction of the histopathologic nature of a given lesion from various sources of medical imaging; (3) prognostication; (4) extraction of pathological findings from imaging; and (5) different applications in radiation oncology. In addition, the challenges in implementation of AI/ML models for clinical evaluations include the lack of standardized methodological guidelines for the collection of clinical images, development of these models, reporting of their performance, external validation procedures, and regulatory frameworks. CONCLUSION: At present, there is a paucity of evidence to suggest the adoption of these models in clinical practice due to the aforementioned limitations. Therefore, this manuscript highlights the need for development of standardized guidelines to facilitate the adoption and implementation of these models in the daily clinical practice. In addition, adequately powered, prospective, randomized controlled trials are urgently needed to further assess the potential of AI/ML models in real-world clinical settings for the management of HNC. ispartof: ADVANCES IN THERAPY vol:40 issue:8 ispartof: location:United States status: Published online

Published
2023

7. Recurrent Differentiated Thyroid Cancer: The Current Treatment Options

Author

Coca-Pelaz, Andrés, primary, Rodrigo, Juan Pablo, additional, Shah, Jatin P., additional, Nixon, Iain J., additional, Hartl, Dana M., additional, Robbins, K. Thomas, additional, Kowalski, Luiz P., additional, Mäkitie, Antti A., additional, Hamoir, Marc, additional, López, Fernando, additional, Saba, Nabil F., additional, Nuyts, Sandra, additional, Rinaldo, Alessandra, additional, and Ferlito, Alfio, additional

Published
2023
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8. Lymph Node Metastases from Non-Melanoma Skin Cancer of the Head and Neck

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Civantos, Francisco, Helmen, Zachary M, Bradley, Patrick J, Coca-Pelaz, Andrés, De Bree, Remco, Guntinas-Lichius, Orlando, Kowalski, Luiz P, López, Fernando, Mäkitie, Antti A, Rinaldo, Alessandra, Robbins, K Thomas, Rodrigo, Juan P, Takes, Robert P, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Civantos, Francisco, Helmen, Zachary M, Bradley, Patrick J, Coca-Pelaz, Andrés, De Bree, Remco, Guntinas-Lichius, Orlando, Kowalski, Luiz P, López, Fernando, Mäkitie, Antti A, Rinaldo, Alessandra, Robbins, K Thomas, Rodrigo, Juan P, Takes, Robert P, and Ferlito, Alfio

Published
2023

9. Survival Outcomes in T3 Laryngeal Cancers: Primary Total Laryngectomy vs. Concurrent Chemoradiation or Radiation Therapy—A Meta-Analysis †

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Rao, Karthik Nagaraja, Pai, Prathamesh S., Dange, Prajwal, Kowalski, Luiz P., Strojan, Primož, Mäkitie, Antti A., Guntinas-Lichius, Orlando, Robbins, K. Thomas, Rodrigo, Juan P., Eisbruch, Avraham, Takes, Robert P., de Bree, Remco, Coca-Pelaz, Andrés, Piazza, Cesare, Chiesa-Estomba, Carlos, López, Fernando, Saba, Nabil F., Rinaldo, Alessandra, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Rao, Karthik Nagaraja, Pai, Prathamesh S., Dange, Prajwal, Kowalski, Luiz P., Strojan, Primož, Mäkitie, Antti A., Guntinas-Lichius, Orlando, Robbins, K. Thomas, Rodrigo, Juan P., Eisbruch, Avraham, Takes, Robert P., de Bree, Remco, Coca-Pelaz, Andrés, Piazza, Cesare, Chiesa-Estomba, Carlos, López, Fernando, Saba, Nabil F., Rinaldo, Alessandra, and Ferlito, Alfio

Published
2023

10. Management of Older Patients with Head and Neck Cancer: A Comprehensive Review

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Matos, Leandro L, Sanabria, Alvaro, Robbins, K Thomas, Halmos, Gyorgy B, Strojan, Primož, Ng, Wai Tong, Takes, Robert P, Angelos, Peter, Piazza, Cesare, de Bree, Remco, Ronen, Ohad, Guntinas-Lichius, Orlando, Eisbruch, Avraham, Zafereo, Mark, Mäkitie, Antti A, Shaha, Ashok R, Coca-Pelaz, Andres, Rinaldo, Alessandra, Saba, Nabil F, Cohen, Oded, Lopez, Fernando, Rodrigo, Juan P, Silver, Carl E, Strandberg, Timo E, Kowalski, Luiz Paulo, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Matos, Leandro L, Sanabria, Alvaro, Robbins, K Thomas, Halmos, Gyorgy B, Strojan, Primož, Ng, Wai Tong, Takes, Robert P, Angelos, Peter, Piazza, Cesare, de Bree, Remco, Ronen, Ohad, Guntinas-Lichius, Orlando, Eisbruch, Avraham, Zafereo, Mark, Mäkitie, Antti A, Shaha, Ashok R, Coca-Pelaz, Andres, Rinaldo, Alessandra, Saba, Nabil F, Cohen, Oded, Lopez, Fernando, Rodrigo, Juan P, Silver, Carl E, Strandberg, Timo E, Kowalski, Luiz Paulo, and Ferlito, Alfio

Published
2023

11. Neck Surgery for Non-Well Differentiated Thyroid Malignancies: Variations in Strategy According to Histopathology

Author

López, Fernando, primary, Al Ghuzlan, Abir, additional, Zafereo, Mark, additional, Vander Poorten, Vincent, additional, Robbins, K. Thomas, additional, Hamoir, Marc, additional, Nixon, Iain J., additional, Tufano, Ralph P., additional, Randolph, Gregory, additional, Pace-Asciak, Pia, additional, Angelos, Peter, additional, Coca-Pelaz, Andrés, additional, Khafif, Avi, additional, Ronen, Ohad, additional, Rodrigo, Juan Pablo, additional, Sanabria, Álvaro, additional, Palme, Carsten E., additional, Mäkitie, Antti A., additional, Kowalski, Luiz P., additional, Rinaldo, Alessandra, additional, and Ferlito, Alfio, additional

Published
2023
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13. Current Radiotherapy Considerations for Nasopharyngeal Carcinoma

Author

Ng, Wai Tong, primary, Chow, James C. H., additional, Beitler, Jonathan J., additional, Corry, June, additional, Mendenhall, William, additional, Lee, Anne W. M., additional, Robbins, K Thomas, additional, Nuyts, Sandra, additional, Saba, Nabil F., additional, Smee, Robert, additional, Stokes, William A., additional, Strojan, Primož, additional, and Ferlito, Alfio, additional

Published
2022
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14. Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review

Author

Guntinas-Lichius, Orlando, Thielker, Jovanna, Robbins, K. Thomas, Olsen, Kerry D., Shaha, Ashok R., Mäkitie, Antti A., de Bree, Remco, Vander Poorten, Vincent, Quer, Miquel, Rinaldo, Alessandra, Kowalski, Luiz Paulo, Rodrigo, Juan Pablo, Hamoir, Marc, Ferlito, Alfio, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Helsinki University Hospital Area, Research Program in Systems Oncology, Research Programs Unit, and Faculty of Medicine

Subjects
GLAND, nodal metastasis, clinical significance, intraparotid lymph node metastasis, prevalence, MANAGEMENT, primary parotid cancer, SQUAMOUS-CELL CARCINOMA, 3125 Otorhinolaryngology, ophthalmology, survival, NECK, MUCOEPIDERMOID CARCINOMA
Abstract

Background The prognostic importance of intraparotid lymph node metastasis (P+) in patients with primary parotid gland carcinoma is unclear. Methods Nineteen retrospective and noncomparative cohort studies, published between 1992 and 2020, met the inclusion criteria and included 2202 patients for this systematic review. Results The pooled prevalence of the P in adult patients in the unselected studies was 24.10% (95% confidence interval = 17.95-30.25). The number of P+ lymph nodes per patient was counted in only three studies and ranged from 1 to 11. The 5-year recurrence-free survival rate based on Kaplan-Meier analysis varied from 83% to 88% in P- patients compared to 36% to 54% in P+ patients. The average hazard ratio for tumor recurrence in patients with P+ compared to P- was 2.67 +/- 0.58. Conclusions P+ is an independent negative prognostic factor in primary parotid gland cancer and should be included into the treatment planning.

Published
2021

15. Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review.

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Guntinas-Lichius, Orlando, Thielker, Jovanna, Robbins, K Thomas, Olsen, Kerry D, Shaha, Ashok R, Mäkitie, Antti A, de Bree, Remco, Vander Poorten, Vincent, Quer, Miquel, Rinaldo, Alessandra, Kowalski, Luiz Paulo, Rodrigo, Juan Pablo, Hamoir, Marc, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Guntinas-Lichius, Orlando, Thielker, Jovanna, Robbins, K Thomas, Olsen, Kerry D, Shaha, Ashok R, Mäkitie, Antti A, de Bree, Remco, Vander Poorten, Vincent, Quer, Miquel, Rinaldo, Alessandra, Kowalski, Luiz Paulo, Rodrigo, Juan Pablo, Hamoir, Marc, and Ferlito, Alfio

Abstract

BACKGROUND: The prognostic importance of intraparotid lymph node metastasis (P+) in patients with primary parotid gland carcinoma is unclear. METHODS: Nineteen retrospective and noncomparative cohort studies, published between 1992 and 2020, met the inclusion criteria and included 2202 patients for this systematic review. RESULTS: The pooled prevalence of the P in adult patients in the unselected studies was 24.10% (95% confidence interval = 17.95-30.25). The number of P+ lymph nodes per patient was counted in only three studies and ranged from 1 to 11. The 5-year recurrence-free survival rate based on Kaplan-Meier analysis varied from 83% to 88% in P- patients compared to 36% to 54% in P+ patients. The average hazard ratio for tumor recurrence in patients with P+ compared to P- was 2.67 ± 0.58. CONCLUSIONS: P+ is an independent negative prognostic factor in primary parotid gland cancer and should be included into the treatment planning.

Published
2021

16. Standardization for oncologic head and neck surgery

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Ronen, Ohad, Robbins, K. Thomas, de Bree, Remco, Guntinas-Lichius, Orlando, Hartl, Dana M., Homma, Akihiro, Khafif, Avi, Kowalski, Luiz P., López, Fernando, Mäkitie, Antti A., Ng, Wai Tong, Rinaldo, Alessandra, Rodrigo, Juan P., Sanabria, Alvaro, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Ronen, Ohad, Robbins, K. Thomas, de Bree, Remco, Guntinas-Lichius, Orlando, Hartl, Dana M., Homma, Akihiro, Khafif, Avi, Kowalski, Luiz P., López, Fernando, Mäkitie, Antti A., Ng, Wai Tong, Rinaldo, Alessandra, Rodrigo, Juan P., Sanabria, Alvaro, and Ferlito, Alfio

Published
2021

17. Contemporary management of the neck in nasopharyngeal carcinoma

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Ng, Wai Tong, Tsang, Raymond K.Y., Beitler, Jonathan J., de Bree, Remco, Coca-Pelaz, Andrés, Eisbruch, Avraham, Guntinas-Lichius, Orlando, Lee, Anne W.M., Mäkitie, Antti A., Mendenhall, William M., Nuyts, Sandra, Rinaldo, Alessandra, Robbins, K. Thomas, Rodrigo, Juan P., Silver, Carl E., Simo, Ricard, Smee, Robert, Strojan, Primož, Takes, Robert P., Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Ng, Wai Tong, Tsang, Raymond K.Y., Beitler, Jonathan J., de Bree, Remco, Coca-Pelaz, Andrés, Eisbruch, Avraham, Guntinas-Lichius, Orlando, Lee, Anne W.M., Mäkitie, Antti A., Mendenhall, William M., Nuyts, Sandra, Rinaldo, Alessandra, Robbins, K. Thomas, Rodrigo, Juan P., Silver, Carl E., Simo, Ricard, Smee, Robert, Strojan, Primož, Takes, Robert P., and Ferlito, Alfio

Published
2021

18. Prognostic role of intraparotid lymph node metastasis in primary parotid cancer: Systematic review

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Guntinas-Lichius, Orlando, Thielker, Jovanna, Robbins, K Thomas, Olsen, Kerry D, Shaha, Ashok R, Mäkitie, Antti A, de Bree, Remco, Vander Poorten, Vincent, Quer, Miquel, Rinaldo, Alessandra, Kowalski, Luiz Paulo, Rodrigo, Juan Pablo, Hamoir, Marc, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Guntinas-Lichius, Orlando, Thielker, Jovanna, Robbins, K Thomas, Olsen, Kerry D, Shaha, Ashok R, Mäkitie, Antti A, de Bree, Remco, Vander Poorten, Vincent, Quer, Miquel, Rinaldo, Alessandra, Kowalski, Luiz Paulo, Rodrigo, Juan Pablo, Hamoir, Marc, and Ferlito, Alfio

Published
2021

19. Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level : A Systematic Review

Author

Sanabria, Alvaro, Shah, Jatin P., Medina, Jesus E., Olsen, Kerry D., Robbins, K. Thomas, Silver, Carl E., Rodrigo, Juan P., Suarez, Carlos, Coca-Pelaz, Andres, Shaha, Ashok R., Mäkitie, Antti A., Rinaldo, Alessandra, de Bree, Remco, Strojan, Primoz, Hamoir, Marc, Takes, Robert P., Sjogren, Elisabeth V., Cannon, Trinitia, Kowalski, Luiz P., Ferlito, Alfio, HUS Head and Neck Center, Department of Ophthalmology and Otorhinolaryngology, University of Helsinki, and Helsinki University Hospital Area

Subjects
SELECTIVE NECK, N-0 NECK, CLINICALLY NEGATIVE NECK, SUPPORT PRESERVATION, 3122 Cancers, ELECTIVE LATERAL NECK, CANCER, larynx neoplasm, SUBLEVEL IIB, supraglottis, systematic review, SURGICAL-MANAGEMENT, glottis, N0 NECK, neck dissection, DISSECTION
Abstract

Background: Larynx cancer is a common site for tumors of the upper aerodigestive tract. In cases with a clinically negative neck, the indications for an elective neck treatment are still debated. The objective is to define the prevalence of occult metastasis based on the subsite of the primary tumor, T classification and neck node levels involved. Methods: All studies included provided the rate of occult metastases in cN0 larynx squamous cell carcinoma patients. The main outcome was the incidence of occult metastasis. The pooled incidence was calculated with random effects analysis. Results: 36 studies with 3803 patients fulfilled the criteria. The incidence of lymph node metastases for supraglottic and glottic tumors was 19.9% (95% CI 16.4-23.4) and 8.0% (95% CI 2.7-13.3), respectively. The incidence of occult metastasis for level I, level IV and level V was 2.4% (95% CI 0-6.1%), 2.0% (95% CI 0.9-3.1) and 0.4% (95% CI 0-1.0%), respectively. For all tumors, the incidence for sublevel IIB was 0.5% (95% CI 0-1.3). Conclusions: The incidence of occult lymph node metastasis is higher in supraglottic and T3-4 tumors. Level I and V and sublevel IIB should not be routinely included in the elective neck treatment of cN0 laryngeal cancer and, in addition, level IV should not be routinely included in cases of supraglottic tumors.

Published
2020

20. Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery : A Systematic Review and Meta-Analysis

Author

Vander Poorten, Vincent, Uyttebroek, Saartje, Robbins, K. Thomas, Rodrigo, Juan P., de Bree, Remco, Laenen, Annouschka, Saba, Nabil F., Suarez, Carlos, Mäkitie, Antti, Rinaldo, Alessandra, Ferlito, Alfio, HUS Head and Neck Center, University Management, Department of Ophthalmology and Otorhinolaryngology, University of Helsinki, and Helsinki University Hospital Area

Subjects
COMPLICATIONS, Prophylaxis, Head and neck oncology, Head and neck surgery, ANTIMICROBIAL PROPHYLAXIS, Guidelines, CLINDAMYCIN PROPHYLAXIS, Perioperative antibiotics, FREE-FLAP RECONSTRUCTION, CEFAZOLIN, Meta-analysis, METRONIDAZOLE, 317 Pharmacy, Systematic review, SURGICAL SITE INFECTION, MAJOR HEAD, SHORT-TERM, Evidence based, ONCOLOGIC SURGERY, 3125 Otorhinolaryngology, ophthalmology
Abstract

BackgroundThe optimal evidence-based prophylactic antibiotic regimen for surgical site infections following major head and neck surgery remains a matter of debate.MethodsMedline, Cochrane, and Embase were searched for the current best evidence. Retrieved manuscripts were screened according to the PRISMA guidelines. Included studies dealt with patients over 18 years of age that underwent clean-contaminated head and neck surgery (P) and compared the effect of an intervention, perioperative administration of different antibiotic regimens for a variable duration (I), with control groups receiving placebo, another antibiotic regimen, or the same antibiotic for a different postoperative duration (C), on surgical site infection rate as primary outcome (O) (PICO model). A systematic review was performed, and a selected group of trials investigating a similar research question was subjected to a random-effects model meta-analysis.ResultsThirty-nine studies were included in the systematic review. Compared with placebo, cefazolin, ampicillin-sulbactam, and amoxicillin-clavulanate were the most efficient agents. Benzylpenicillin and clindamycin were clearly less effective. Fifteen studies compared short- to long-term prophylaxis; treatment for more than 48 h did not further reduce wound infections. Meta-analysis of five clinical trials including 4336 patients, where clindamycin was compared with ampicillin-sulbactam, implied an increased infection rate for clindamycin-treated patients (OR=2.73, 95% CI 1.50-4.97, p=0.001).ConclusionIn clean-contaminated head and neck surgery, cefazolin, amoxicillin-clavulanate, and ampicillin-sulbactam for 24-48 h after surgery were associated with the highest prevention rate of surgical site infection.

Published
2020

21. Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review.

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Sanabria, Alvaro, Shah, Jatin P, Medina, Jesus E, Olsen, Kerry D, Robbins, K Thomas, Silver, Carl E, Rodrigo, Juan P, Suárez, Carlos, Coca-Pelaz, Andrés, Shaha, Ashok R, Mäkitie, Antti A, Rinaldo, Alessandra, de Bree, Remco, Strojan, Primož, Hamoir, Marc, Takes, Robert P, Sjögren, Elisabeth V, Cannon, Trinitia, Kowalski, Luiz P, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Sanabria, Alvaro, Shah, Jatin P, Medina, Jesus E, Olsen, Kerry D, Robbins, K Thomas, Silver, Carl E, Rodrigo, Juan P, Suárez, Carlos, Coca-Pelaz, Andrés, Shaha, Ashok R, Mäkitie, Antti A, Rinaldo, Alessandra, de Bree, Remco, Strojan, Primož, Hamoir, Marc, Takes, Robert P, Sjögren, Elisabeth V, Cannon, Trinitia, Kowalski, Luiz P, and Ferlito, Alfio

Abstract

BACKGROUND: Larynx cancer is a common site for tumors of the upper aerodigestive tract. In cases with a clinically negative neck, the indications for an elective neck treatment are still debated. The objective is to define the prevalence of occult metastasis based on the subsite of the primary tumor, T classification and neck node levels involved. METHODS: All studies included provided the rate of occult metastases in cN0 larynx squamous cell carcinoma patients. The main outcome was the incidence of occult metastasis. The pooled incidence was calculated with random effects analysis. RESULTS: 36 studies with 3803 patients fulfilled the criteria. The incidence of lymph node metastases for supraglottic and glottic tumors was 19.9% (95% CI 16.4-23.4) and 8.0% (95% CI 2.7-13.3), respectively. The incidence of occult metastasis for level I, level IV and level V was 2.4% (95% CI 0-6.1%), 2.0% (95% CI 0.9-3.1) and 0.4% (95% CI 0-1.0%), respectively. For all tumors, the incidence for sublevel IIB was 0.5% (95% CI 0-1.3). CONCLUSIONS: The incidence of occult lymph node metastasis is higher in supraglottic and T3-4 tumors. Level I and V and sublevel IIB should not be routinely included in the elective neck treatment of cN0 laryngeal cancer and, in addition, level IV should not be routinely included in cases of supraglottic tumors.

Published
2020

22. Management of the Neck in Well-Differentiated Thyroid Cancer.

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Asimakopoulos, Panagiotis, Shaha, Ashok R, Nixon, Iain J, Shah, Jatin P, Randolph, Gregory W, Angelos, Peter, Zafereo, Mark E, Kowalski, Luiz P, Hartl, Dana M, Olsen, Kerry D, Rodrigo, Juan P, Vander Poorten, Vincent, Mäkitie, Antti A, Sanabria, Alvaro, Suárez, Carlos, Quer, Miquel, Civantos, Francisco J, Robbins, K Thomas, Guntinas-Lichius, Orlando, Hamoir, Marc, Rinaldo, Alessandra, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Asimakopoulos, Panagiotis, Shaha, Ashok R, Nixon, Iain J, Shah, Jatin P, Randolph, Gregory W, Angelos, Peter, Zafereo, Mark E, Kowalski, Luiz P, Hartl, Dana M, Olsen, Kerry D, Rodrigo, Juan P, Vander Poorten, Vincent, Mäkitie, Antti A, Sanabria, Alvaro, Suárez, Carlos, Quer, Miquel, Civantos, Francisco J, Robbins, K Thomas, Guntinas-Lichius, Orlando, Hamoir, Marc, Rinaldo, Alessandra, and Ferlito, Alfio

Abstract

PURPOSE OF REVIEW: In this narrative review, we discuss the indications for elective and therapeutic neck dissections and the postoperative surveillance and treatment options for recurrent nodal disease in patients with well-differentiated thyroid cancer. RECENT FINDINGS: Increased availability of advanced imaging modalities has led to an increased detection rate of previously occult nodal disease in thyroid cancer. Nodal metastases are more common in young patients, large primary tumors, specific genotypes, and certain histological types. While clinically evident nodal disease in the lateral neck compartments has a significant oncological impact, particularly in the older age group, microscopic metastases to the central or the lateral neck in well-differentiated thyroid cancer do not significantly affect outcome. As patients with clinically evident nodal disease are associated with worse outcomes, they should be treated surgically in order to reduce rates of regional recurrence and improve survival. The benefit of elective neck dissection remains unverified as the impact of microscopic disease on outcomes is not significant.

Published
2020

23. Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery: A Systematic Review and Meta-Analysis

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Vander Poorten, Vincent, Uyttebroek, Saartje, Robbins, K Thomas, Rodrigo, Juan P, de Bree, Remco, Laenen, Annouschka, F Saba, Nabil, Suarez, Carlos, Mäkitie, Antti, Rinaldo, Alessandra, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Vander Poorten, Vincent, Uyttebroek, Saartje, Robbins, K Thomas, Rodrigo, Juan P, de Bree, Remco, Laenen, Annouschka, F Saba, Nabil, Suarez, Carlos, Mäkitie, Antti, Rinaldo, Alessandra, and Ferlito, Alfio

Published
2020

24. Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Sanabria, Alvaro, Shah, Jatin P, Medina, Jesus E, Olsen, Kerry D, Robbins, K Thomas, Silver, Carl E, Rodrigo, Juan P, Suárez, Carlos, Coca-Pelaz, Andrés, Shaha, Ashok R, Mäkitie, Antti A, Rinaldo, Alessandra, de Bree, Remco, Strojan, Primož, Hamoir, Marc, Takes, Robert P, Sjögren, Elisabeth V, Cannon, Trinitia, Kowalski, Luiz P, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Sanabria, Alvaro, Shah, Jatin P, Medina, Jesus E, Olsen, Kerry D, Robbins, K Thomas, Silver, Carl E, Rodrigo, Juan P, Suárez, Carlos, Coca-Pelaz, Andrés, Shaha, Ashok R, Mäkitie, Antti A, Rinaldo, Alessandra, de Bree, Remco, Strojan, Primož, Hamoir, Marc, Takes, Robert P, Sjögren, Elisabeth V, Cannon, Trinitia, Kowalski, Luiz P, and Ferlito, Alfio

Published
2020

25. Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Civantos, Francisco J, Vermorken, Jan B, Shah, Jatin P, Rinaldo, Alessandra, Suárez, Carlos, Kowalski, Luiz P, Rodrigo, Juan P, Olsen, Kerry, Strojan, Primoz, Mäkitie, Antti A, Takes, Robert P, de Bree, Remco, Corry, June, Paleri, Vinidh, Shaha, Ashok R, Hartl, Dana M, Mendenhall, William, Piazza, Cesare, Hinni, Michael, Robbins, K Thomas, Tong, Ng Wai, Sanabria, Alvaro, Coca-Pelaz, Andres, Langendijk, Johannes A, Hernandez-Prera, Juan, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Civantos, Francisco J, Vermorken, Jan B, Shah, Jatin P, Rinaldo, Alessandra, Suárez, Carlos, Kowalski, Luiz P, Rodrigo, Juan P, Olsen, Kerry, Strojan, Primoz, Mäkitie, Antti A, Takes, Robert P, de Bree, Remco, Corry, June, Paleri, Vinidh, Shaha, Ashok R, Hartl, Dana M, Mendenhall, William, Piazza, Cesare, Hinni, Michael, Robbins, K Thomas, Tong, Ng Wai, Sanabria, Alvaro, Coca-Pelaz, Andres, Langendijk, Johannes A, Hernandez-Prera, Juan, and Ferlito, Alfio

Published
2020

26. Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era

Author

Civantos, Francisco J., primary, Vermorken, Jan B., additional, Shah, Jatin P., additional, Rinaldo, Alessandra, additional, Suárez, Carlos, additional, Kowalski, Luiz P., additional, Rodrigo, Juan P., additional, Olsen, Kerry, additional, Strojan, Primoz, additional, Mäkitie, Antti A., additional, Takes, Robert P., additional, de Bree, Remco, additional, Corry, June, additional, Paleri, Vinidh, additional, Shaha, Ashok R., additional, Hartl, Dana M., additional, Mendenhall, William, additional, Piazza, Cesare, additional, Hinni, Michael, additional, Robbins, K. Thomas, additional, Tong, Ng Wai, additional, Sanabria, Alvaro, additional, Coca-Pelaz, Andres, additional, Langendijk, Johannes A., additional, Hernandez-Prera, Juan, additional, and Ferlito, Alfio, additional

Published
2020
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27. Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review

Author

Sanabria, Alvaro, primary, Shah, Jatin P., additional, Medina, Jesus E., additional, Olsen, Kerry D., additional, Robbins, K. Thomas, additional, Silver, Carl E., additional, Rodrigo, Juan P., additional, Suárez, Carlos, additional, Coca-Pelaz, Andrés, additional, Shaha, Ashok R., additional, Mäkitie, Antti A., additional, Rinaldo, Alessandra, additional, de Bree, Remco, additional, Strojan, Primož, additional, Hamoir, Marc, additional, Takes, Robert P., additional, Sjögren, Elisabeth V., additional, Cannon, Trinitia, additional, Kowalski, Luiz P., additional, and Ferlito, Alfio, additional

Published
2020
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29. An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid gland

Author

Vartanian, Jose Guilherme, Goncalves Filho, Joao, Kowalski, Luiz Paulo, Shah, Jatin P., Suarez, Carlos, Rinaldo, Alessandra, De Bree, Remco, Rodrigo, Juan P., Hamoir, Marc, Takes, Robert P., Makitie, Antti A., Zbaren, Peter, Andreasen, Simon, Poorten, Vincent Vander, Sanabria, Alvaro, Hellquist, Henrik, Robbins, K. Thomas, Boedeker, Carsten C., Silver, Carl, and Ferlito, Alfio

Subjects
Salivary gland, Radiotherapy, Dissection, Biopsy, Salivary-glands, Neck dissection, Adenoid cystic carcinoma, High-grade transformation, Cell-carcinoma, Sentinel node, Lymph-node metastasis, Beta-catenin, Elective neck treatment, Analog secretory carcinoma, Parotid gland
Abstract

Introduction: Management of clinically negative neck (cN0) in patients with parotid gland cancer is controversial. Treatment options can include observation, elective neck dissection or elective radiotherapy. Areas covered: We addressed the treatment options for cN0 patients with parotid gland cancer. A literature review was undertaken to determine the optimal management of this group of patients. Expert opinion: Patients with parotid carcinoma and clinically negative neck have various options for their management. The analysis of tumor stage, histology and grade is essential to better define patients at risk for occult lymph node metastasis. These patients can be managed by surgery, radiotherapy or their combination, depending on the presence of risk factors, the moment at which such risk factors are detected, patient-related clinical conditions, medical provider expertise and institutional facilities. info:eu-repo/semantics/publishedVersion

Published
2019

30. Surgical margins in head and neck cancer: Intra- and postoperative considerations

Author

Robbins, K. Thomas, Triantafyllou, A., Suarez, C., Lopez, F., Hunt, J.L., Strojan, P., Williams, M.D., Braakhuis, B.J., Bree, R. de, Hinni, M.L., Kowalski, L.P., Rinaldo, A., Rodrigo, J.P., Poorten, V. Van der, Nixon, I.J., Takes, R.P., Silver, C.E., Ferlito, A., Robbins, K. Thomas, Triantafyllou, A., Suarez, C., Lopez, F., Hunt, J.L., Strojan, P., Williams, M.D., Braakhuis, B.J., Bree, R. de, Hinni, M.L., Kowalski, L.P., Rinaldo, A., Rodrigo, J.P., Poorten, V. Van der, Nixon, I.J., Takes, R.P., Silver, C.E., and Ferlito, A.

Abstract

Contains fulltext : 203203.pdf (publisher's version ) (Closed access), OBJECTIVE: To provide a perspective on the significance of recent reports for optimizing cancer free surgical margins that have challenged standard practices. METHODS: We conducted a review of the recent literature (2012-2018) using the keywords surgical margin analysis, frozen and paraffin section techniques, head and neck cancer, spectroscopy and molecular markers. RESULTS: Of significance are the reports indicating superiority of tumor specimen directed sampling of margins compared to patient directed (tumor bed) sampling for frozen section control of oral cancers. With reference to optimal distance between tumor and the surgical margin, recent reports recommended cutoffs less than 5mm. Employment of new technologies such as light spectroscopy and molecular analysis of tissues, provide opportunities for a "real time" assessment of surgical margins. CONCLUSIONS: The commonly practiced method of patient directed margin sampling involving previous studies raises concern over conclusions made regarding the efficacy of frozen section margin control. The recent studies that challenge the optimal distance for clear surgical margins are retrospective and address patient cohorts with inherently confounding factors. The use of novel ancillary techniques require further refinements, clinical trial validation, and justification based on the additional resources.

Published
2019

31. Elective neck dissection in oral squamous cell carcinoma : Past, present and future

Author

de Bree, Remco, Takes, Robert P, Shah, Jatin P, Hamoir, Marc, Kowalski, Luiz P, Robbins, K Thomas, Rodrigo, Juan P, Sanabria, Alvaro, Medina, Jesus E, Rinaldo, Alessandra, Shaha, Ashok R, Silver, Carl, Suárez, Carlos, Bernal-Sprekelsen, Manuel, Ferlito, Alfio, de Bree, Remco, Takes, Robert P, Shah, Jatin P, Hamoir, Marc, Kowalski, Luiz P, Robbins, K Thomas, Rodrigo, Juan P, Sanabria, Alvaro, Medina, Jesus E, Rinaldo, Alessandra, Shaha, Ashok R, Silver, Carl, Suárez, Carlos, Bernal-Sprekelsen, Manuel, and Ferlito, Alfio

Published
2019

32. An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid gland

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Vartanian, Jose Guilherme, Gonçalves Filho, Joao, Kowalski, Luiz Paulo, Shah, Jatin P., Suárez, Carlos, Rinaldo, Alessandra, De Bree, Remco, Rodrigo, Juan P, Hamoir, Marc, Takes, Robert P., Mäkitie, Antti A., Zbären, Peter, Andreasen, Simon, Poorten, Vincent Vander, Sanabria, Alvaro, Hellquist, Henrik, Robbins, K. Thomas, Bödeker, Carsten C., Silver, Carl, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Vartanian, Jose Guilherme, Gonçalves Filho, Joao, Kowalski, Luiz Paulo, Shah, Jatin P., Suárez, Carlos, Rinaldo, Alessandra, De Bree, Remco, Rodrigo, Juan P, Hamoir, Marc, Takes, Robert P., Mäkitie, Antti A., Zbären, Peter, Andreasen, Simon, Poorten, Vincent Vander, Sanabria, Alvaro, Hellquist, Henrik, Robbins, K. Thomas, Bödeker, Carsten C., Silver, Carl, and Ferlito, Alfio

Abstract

INTRODUCTION: Management of clinically negative neck (cN0) in patients with parotid gland cancer is controversial. Treatment options can include observation, elective neck dissection or elective radiotherapy. AREAS COVERED: We addressed the treatment options for cN0 patients with parotid gland cancer. A literature review was undertaken to determine the optimal management of this group of patients. EXPERT OPINION: Patients with parotid carcinoma and clinically negative neck have various options for their management. The analysis of tumor stage, histology and grade is essential to better define patients at risk for occult lymph node metastasis. These patients can be managed by surgery, radiotherapy or their combination, depending on the presence of risk factors, the moment at which such risk factors are detected, patient-related clinical conditions, medical provider expertise and institutional facilities.

Published
2019

33. Elective neck dissection in oral squamous cell carcinoma: Past, present and future

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, de Bree, Remco, Takes, Robert P., Shah, Jatin P., Hamoir, Marc, Kowalski, Luiz P., Robbins, K. Thomas, Rodrigo, Juan P., Sanabria, Alvaro, Medina, Jesus E., Rinaldo, Alessandra, Shaha, Ashok R., Silver, Carl, Suárez, Carlos, Bernal-Sprekelsen, Manuel, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, de Bree, Remco, Takes, Robert P., Shah, Jatin P., Hamoir, Marc, Kowalski, Luiz P., Robbins, K. Thomas, Rodrigo, Juan P., Sanabria, Alvaro, Medina, Jesus E., Rinaldo, Alessandra, Shaha, Ashok R., Silver, Carl, Suárez, Carlos, Bernal-Sprekelsen, Manuel, and Ferlito, Alfio

Abstract

In 1994 a decision analysis, based on the literature and utility ratings for outcome by a panel of experienced head and neck physicians, was presented which showed a threshold probability of occult metastases of 20% to recommend elective treatment of the neck. It was stated that recommendations for the management of the cN0 neck are not immutable and should be reconfigured to determine the optimal management based on different sets of underlying assumptions. Although much has changed and is published in the almost 25 years after its publication, up to date this figure is still mentioned in the context of decisions on treatment of the clinically negative (cN0) neck. Therefore, we critically reviewed the developments in diagnostics and therapy and modeling approaches in the context of decisions on treatment of the cN0 neck. However, the results of studies on treatment of the cN0 neck cannot be translated to other settings due to significant differences in relevant variables such as population, culture, diagnostic work-up, follow-up, costs, institutional preferences and other factors. Moreover, patients may have personal preferences and may weigh oncologic outcomes versus morbidity and quality of life differently. Therefore, instead of trying to establish “the” best strategy for the cN0 neck or “the” optimal cut-off point for elective neck treatment, the approach to optimize the management of the cN0 neck would be to develop and implement models and decision support systems that can serve to optimize choices depending on individual, institutional, population and other relevant variables.

Published
2019

34. An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid gland

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Vartanian, Jose Guilherme, Gonçalves Filho, Joao, Kowalski, Luiz Paulo, Shah, Jatin P., Suárez, Carlos, Rinaldo, Alessandra, De Bree, Remco, Rodrigo, Juan P., Hamoir, Marc, Takes, Robert P., Mäkitie, Antti A., Zbären, Peter, Andreasen, Simon, Poorten, Vincent Vander, Sanabria, Alvaro, Hellquist, Henrik, Robbins, K. Thomas, Bödeker, Carsten C., Silver, Carl, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Vartanian, Jose Guilherme, Gonçalves Filho, Joao, Kowalski, Luiz Paulo, Shah, Jatin P., Suárez, Carlos, Rinaldo, Alessandra, De Bree, Remco, Rodrigo, Juan P., Hamoir, Marc, Takes, Robert P., Mäkitie, Antti A., Zbären, Peter, Andreasen, Simon, Poorten, Vincent Vander, Sanabria, Alvaro, Hellquist, Henrik, Robbins, K. Thomas, Bödeker, Carsten C., Silver, Carl, and Ferlito, Alfio

Published
2019

35. Elective neck dissection in oral squamous cell carcinoma: Past, present and future

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, de Bree, Remco, Takes, Robert P, Shah, Jatin P, Hamoir, Marc, Kowalski, Luiz P, Robbins, K Thomas, Rodrigo, Juan P, Sanabria, Alvaro, Medina, Jesus E, Rinaldo, Alessandra, Shaha, Ashok R, Silver, Carl, Suárez, Carlos, Bernal-Sprekelsen, Manuel, Ferlito, Alfio, MS Hoofd-Hals Chirurgische Oncologie, Cancer, de Bree, Remco, Takes, Robert P, Shah, Jatin P, Hamoir, Marc, Kowalski, Luiz P, Robbins, K Thomas, Rodrigo, Juan P, Sanabria, Alvaro, Medina, Jesus E, Rinaldo, Alessandra, Shaha, Ashok R, Silver, Carl, Suárez, Carlos, Bernal-Sprekelsen, Manuel, and Ferlito, Alfio

Published
2019

36. The Role of Adjuvant Treatment in Early-Stage Oral Cavity Squamous Cell Carcinoma: An International Collaborative Study

Author

Fridman, Eran, Na’ara, Shorook, Agarwal, Jaiprakash, Amit, Moran, Bachar, Gideon, Villaret, Andrea Bolzoni, Brandao, Jose, Cernea, Claudio R., Chaturvedi, Pankaj, Clark, Jonathan, Ebrahimi, Ardalan, Fliss, Dan M., Jonnalagadda, Sashikanth, Kohler, Hugo F., Kowalski, Luiz P., Kreppel, Matthias, Liao, Chun-Ta, Patel, Snehal G., Patel, Rajan S., Robbins, K. Thomas, Shah, Jatin P., Shpitzer, Thomas, Yen, Tzu-Chen, Zöller, Joachim E., and Gil, Ziv

Subjects
Article
Abstract

BACKGROUND: Up to half of patients with oral cavity squamous cell carcinoma (OCSCC) have stage I to II disease. When adequate resection is attained, no further treatment is needed; however, re-resection or radiotherapy may be indicated for patients with positive or close margins. This multicenter study evaluated the outcomes and role of adjuvant treatment in patients with stage I to II OCSCC. METHODS: Overall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis. RESULTS: Of 1257 patients with T1–2N0M0 disease, 33 (2.6%) had positive margins, and 205 (16.3%) had close margins. The 5-year OS rate was 80% for patients with clear margins, 52% for patients with close margins, and 63% for patients with positive margins (P 2-fold increase in the risk of recurrence (P

Published
2018

37. Intra-arterial chemoradiation for T3-4 oral cavity cancer: Treatment outcomes in comparison to oropharyngeal and hypopharyngeal carcinoma

Author

Samant Sandeep, Robbins K Thomas, Doweck Ilana, and Vieira Francisco

Subjects
Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Surgery followed by radiotherapy is the standard of care for resectable locally advanced oral cavity squamous cell carcinoma (SCC). We report the treatment outcomes of patients with T3-T4 SCC of the oral cavity treated with chemoradiation, an alternative approach. Patients and methods From a series of 240 patients with stage III-IV carcinoma of the upper aerodigestive tract who were treated consecutively according to the RADPLAT protocol, a subset analysis of 155 patients with T3-T4 SCC (Oral cavity SCC N = 22, oropharynx SCC N = 94 and hypopharynx SCC N = 39), was performed. The goal was to test the hypothesis that oral cavity SCC treated with chemoradiation has similar outcomes to the two comparison sites. Results With a median follow-up of 58 months, local disease control was 69% and the overall survival was 37%. In comparison, local disease control for the oropharynx and hypopharynx groups was 86% and 79% respectively. The overall survival rate for the oropharyngeal and hypopharyngeal groups were 41% and 6% respectively Conclusion Patients with locally advanced oral cavity cancer treated with the chemoradiation protocol RADPLAT have outcomes that are equal or better compared to patients with similar disease involving the oropharynx and hypopharynx

Published
2008
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38. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

Author

Medina, Jesus E., Robbins, K. Thomas, Silver, Carl E., Strojan, Primoz, Teymoortash, Afshin, Pellitteri, Phillip K., Rodrigo, Juan P., Stoeckli, Sandro J., Shaha, Ashok R., Suarez, Carlos, Hartl, Dana M., De Bree, Remco, Takes, Robert P., Hamoir, Marc, Pitman, Karen T., Rinaldo, Alessandra, Ferlito, Alfio, Uludağ Üniversitesi/Tıp Fakültesi/Kulak Burun Boğaz-Baş Boyun Cerrahisi Anabilim Dalı., and Çoşkun, Hakan H.

Subjects
Male, Secondary, Selective neck, Procedures, Larynx squamous cell carcinoma, Pathology, Treatment outcome, Disease free survival, Lymph nodes, Hypopharynx carcinoma, Risk assessment, Priority journal, Accessory nerve function, Oropharyngeal cancer, Chemoradiotherapy, Upper aerodigestive tract, Prognosis, Lymph-node metastases, Antineoplastic agent, Head and Neck Neoplasms, Female, Lymph node, Neck metastasis, Human, Evidence-based medicine, Elective neck, Disease-free survival, Carcinoma, squamous cell, Lymphatic metastasis, Predictive value, Neck dissection, Lymph node dissection, Article, Evidence based practice, Clinically positive neck, Humans, Neck Dissection, Squamous Cell Carcinoma Of Head And Neck, Sentinel Lymph Node Biopsy, Mortality, Oropharynx carcinoma, Lymph node metastasis, Head and neck squamous cell carcinoma, Level-IIb, Survival analysis, Oral-cavity cancers, Lymph node excision, Philosophy, Clinically negative neck, Sentinel node, Otorhinolaryngology, Evidence based medicine, Surgery
Abstract

Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach. United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI) (P30CA008748) United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI) (P30 CA008748)

Published
2015

39. Cervical lymph node metastases from remote primary tumor sites.

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, López, Fernando, Rodrigo, Juan P., Silver, Carl E., Haigentz, Missak, Bishop, Justin A., Strojan, Primož, Hartl, Dana M., Bradley, Patrick J., Mendenhall, William M., Suárez, Carlos, Takes, Robert P., Hamoir, Marc, Robbins, K. Thomas, Shaha, Ashok R., Werner, Jochen A., Rinaldo, Alessandra, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, López, Fernando, Rodrigo, Juan P., Silver, Carl E., Haigentz, Missak, Bishop, Justin A., Strojan, Primož, Hartl, Dana M., Bradley, Patrick J., Mendenhall, William M., Suárez, Carlos, Takes, Robert P., Hamoir, Marc, Robbins, K. Thomas, Shaha, Ashok R., Werner, Jochen A., Rinaldo, Alessandra, and Ferlito, Alfio

Abstract

Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

Published
2016

40. Cervical Lymph Node Metastasis in Adenoid Cystic Carcinoma of the Larynx: A Collective International Review.

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Coca-Pelaz, Andrés, Barnes, Leon, Rinaldo, Alessandra, Cardesa, Antonio, Shah, Jatin P, Rodrigo, Juan P, Suárez, Carlos, Eloy, Jean Anderson, Bishop, Justin A, Devaney, Kenneth O, Thompson, Lester D R, Wenig, Bruce M, Strojan, Primož, Hamoir, Marc, Bradley, Patrick J, Gnepp, Douglas R, Silver, Carl E, Slootweg, Pieter J, Triantafyllou, Asterios, Vander Poorten, Vincent, Williams, Michelle D, Skálová, Alena, Hellquist, Henrik, Teymoortash, Afshin, Medina, Jesus E, Robbins, K Thomas, Pitman, Karen T, Kowalski, Luiz P, de Bree, Remco, Mendenhall, William M, Takes, Robert P, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Coca-Pelaz, Andrés, Barnes, Leon, Rinaldo, Alessandra, Cardesa, Antonio, Shah, Jatin P, Rodrigo, Juan P, Suárez, Carlos, Eloy, Jean Anderson, Bishop, Justin A, Devaney, Kenneth O, Thompson, Lester D R, Wenig, Bruce M, Strojan, Primož, Hamoir, Marc, Bradley, Patrick J, Gnepp, Douglas R, Silver, Carl E, Slootweg, Pieter J, Triantafyllou, Asterios, Vander Poorten, Vincent, Williams, Michelle D, Skálová, Alena, Hellquist, Henrik, Teymoortash, Afshin, Medina, Jesus E, Robbins, K Thomas, Pitman, Karen T, Kowalski, Luiz P, de Bree, Remco, Mendenhall, William M, Takes, Robert P, and Ferlito, Alfio

Abstract

Adenoid cystic carcinoma (AdCC) of the head and neck is a well-recognized pathologic entity that rarely occurs in the larynx. Although the 5-year locoregional control rates are high, distant metastasis has a tendency to appear more than 5 years post treatment. Because AdCC of the larynx is uncommon, it is difficult to standardize a treatment protocol. One of the controversial points is the decision whether or not to perform an elective neck dissection on these patients. Because there is contradictory information about this issue, we have critically reviewed the literature from 1912 to 2015 on all reported cases of AdCC of the larynx in order to clarify this issue. During the most recent period of our review (1991-2015) with a more exact diagnosis of the tumor histology, 142 cases were observed of AdCC of the larynx, of which 91 patients had data pertaining to lymph node status. Eleven of the 91 patients (12.1%) had nodal metastasis and, based on this low proportion of patients, routine elective neck dissection is therefore not recommended.

Published
2016

41. Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international review

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Suárez, Carlos, Barnes, Leon, Silver, Carl E, Rodrigo, Juan P, Shah, Jatin P, Triantafyllou, Asterios, Rinaldo, Alessandra, Cardesa, Antonio, Pitman, Karen T, Kowalski, Luiz P, Robbins, K Thomas, Hellquist, Henrik, Medina, Jesus E, de Bree, Remco, Takes, Robert P, Coca-Pelaz, Andrés, Bradley, Patrick J, Gnepp, Douglas R, Teymoortash, Afshin, Strojan, Primož, Mendenhall, William M, Eloy, Jean Anderson, Bishop, Justin A, Devaney, Kenneth O, Thompson, Lester D R, Hamoir, Marc, Slootweg, Pieter J, Vander Poorten, Vincent, Williams, Michelle D, Wenig, Bruce M, Skálová, Alena, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, Suárez, Carlos, Barnes, Leon, Silver, Carl E, Rodrigo, Juan P, Shah, Jatin P, Triantafyllou, Asterios, Rinaldo, Alessandra, Cardesa, Antonio, Pitman, Karen T, Kowalski, Luiz P, Robbins, K Thomas, Hellquist, Henrik, Medina, Jesus E, de Bree, Remco, Takes, Robert P, Coca-Pelaz, Andrés, Bradley, Patrick J, Gnepp, Douglas R, Teymoortash, Afshin, Strojan, Primož, Mendenhall, William M, Eloy, Jean Anderson, Bishop, Justin A, Devaney, Kenneth O, Thompson, Lester D R, Hamoir, Marc, Slootweg, Pieter J, Vander Poorten, Vincent, Williams, Michelle D, Wenig, Bruce M, Skálová, Alena, and Ferlito, Alfio

Abstract

The purpose of this study was to suggest general guidelines in the management of the N0 neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not related to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation.

Published
2016

42. Comparison of the American Joint Committee on Cancer N1 versus N2a nodal categories for predicting survival and recurrence in patients with oral cancer: Time to acknowledge an arbitrary distinction and modify the system

Author

Ebrahimi, Ardalan, Gil, Ziv, Amit, Moran, Yen, Tzu-Chen, Liao, Chun-Ta, Chatturvedi, Pankaj, Agarwal, Jaiprakash, Kowalski, Luiz, Kreppel, Matthias, Cernea, Claudio, Brandao, Jose, Bachar, Gideon, Villaret, Andrea Bolzoni, Fliss, Dan, Fridman, Eran, Robbins, K. Thomas, Shah, Jatin, Patel, Snehal, Clark, Jonathan, Ebrahimi, Ardalan, Gil, Ziv, Amit, Moran, Yen, Tzu-Chen, Liao, Chun-Ta, Chatturvedi, Pankaj, Agarwal, Jaiprakash, Kowalski, Luiz, Kreppel, Matthias, Cernea, Claudio, Brandao, Jose, Bachar, Gideon, Villaret, Andrea Bolzoni, Fliss, Dan, Fridman, Eran, Robbins, K. Thomas, Shah, Jatin, Patel, Snehal, and Clark, Jonathan

Abstract

Background. We hypothesized that pathological N1 (pN1) and N2a (pN2a) nodal disease portend a similar prognosis in patients with oral cancer. Methods. An international multicenter study of 739 oral squamous cell carcinoma (SCC) patients with pN1 or pN2a stage disease was conducted. Multivariable analyses were performed using Cox proportional hazard models to compare locoregional failure, disease-specific survival (DSS), and overall survival (OS). Institutional heterogeneity was assessed using 2-stage random effects meta-analysis techniques. Results. Univariate analysis revealed no difference in locoregional failure (p = .184), DSS (p = .761), or OS (p = .475). Similar results were obtained in adjusted multivariable models and no evidence of institutional heterogeneity was demonstrated. Conclusion. The prognosis of pN2a and pN1 disease is similar in oral SCC suggesting these categories could be combined in future revisions of the nodal staging system to enhance prognostic accuracy. However, these results may reflect more aggressive treatment of N2a disease; hence, we caution against using these data to deintensify treatment. (C) 2015 Wiley Periodicals, Inc.

Published
2016

43. Cervical Lymph Node Metastasis in High-Grade Transformation of Head and Neck Adenoid Cystic Carcinoma: A Collective International Review.

Author

UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Centre du cancer, Hellquist, Henrik, Skálová, Alena, Barnes, Leon, Cardesa, Antonio, Thompson, Lester D R, Triantafyllou, Asterios, Williams, Michelle D, Devaney, Kenneth O, Gnepp, Douglas R, Bishop, Justin A, Wenig, Bruce M, Suárez, Carlos, Rodrigo, Juan P, Coca-Pelaz, Andrés, Strojan, Primož, Shah, Jatin P, Hamoir, Marc, Bradley, Patrick J, Silver, Carl E, Slootweg, Pieter J, Vander Poorten, Vincent, Teymoortash, Afshin, Medina, Jesus E, Robbins, K Thomas, Pitman, Karen T, Kowalski, Luiz P, de Bree, Remco, Mendenhall, William M, Eloy, Jean Anderson, Takes, Robert P, Rinaldo, Alessandra, Ferlito, Alfio, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Centre du cancer, Hellquist, Henrik, Skálová, Alena, Barnes, Leon, Cardesa, Antonio, Thompson, Lester D R, Triantafyllou, Asterios, Williams, Michelle D, Devaney, Kenneth O, Gnepp, Douglas R, Bishop, Justin A, Wenig, Bruce M, Suárez, Carlos, Rodrigo, Juan P, Coca-Pelaz, Andrés, Strojan, Primož, Shah, Jatin P, Hamoir, Marc, Bradley, Patrick J, Silver, Carl E, Slootweg, Pieter J, Vander Poorten, Vincent, Teymoortash, Afshin, Medina, Jesus E, Robbins, K Thomas, Pitman, Karen T, Kowalski, Luiz P, de Bree, Remco, Mendenhall, William M, Eloy, Jean Anderson, Takes, Robert P, Rinaldo, Alessandra, and Ferlito, Alfio

Abstract

Adenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC-HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation.

Published
2016

44. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

Author

Coskun, H. Hakan, Medina, Jesus E., Robbins, K. Thomas, Silver, Carl E., Strojan, Primož, Teymoortash, Afshin, Pellitteri, Phillip K., Rodrigo, Juan P., Stoeckli, Sandro J., Shaha, Ashok R., Suçrez, Carlos, Hartl, Dana M., de Bree, Remco, Takes, Robert P., Hamoir, Marc, Pitman, Karen T., Rinaldo, Alessandra, and Ferlito, Alfio

Subjects
Male, Evidence-Based Medicine, Prognosis, Risk Assessment, Survival Analysis, Article, Disease-Free Survival, Treatment Outcome, Head and Neck Neoplasms, Lymphatic Metastasis, Carcinoma, Squamous Cell, Humans, Lymph Node Excision, Neck Dissection, Female, Lymph Nodes
Abstract

Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.

Published
2014

46. Impact of prophylactic central neck dissection on oncologic outcomes of papillary thyroid carcinoma: a review

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Centre de malformations vasculaires congénitales, Mamelle, Elisabeth, Borget, Isabelle, Leboulleux, Sophie, Mirghani, Haïtham, Suárez, Carlos, Pellitteri, Phillip K., Shaha, Ashok R., Hamoir, Marc, Robbins, K. Thomas, Khafif, Avi, Rodrigo, Juan P., Silver, Carl E., Rinaldo, Alessandra, Ferlito, Alfio, Hartl, Dana M., UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Centre de malformations vasculaires congénitales, Mamelle, Elisabeth, Borget, Isabelle, Leboulleux, Sophie, Mirghani, Haïtham, Suárez, Carlos, Pellitteri, Phillip K., Shaha, Ashok R., Hamoir, Marc, Robbins, K. Thomas, Khafif, Avi, Rodrigo, Juan P., Silver, Carl E., Rinaldo, Alessandra, Ferlito, Alfio, and Hartl, Dana M.

Abstract

Prophylactic neck dissection (PND) for papillary thyroid carcinoma (PTC) is controversial. Our aim was to assess current levels of evidence (LE) according to the Oxford Centre for Evidence-based Medicine (http://www.cebm.net/?O=1025) regarding the oncologic benefits of PND. Data were analyzed via MEDLINE keywords: PTC, differentiated thyroid carcinoma, PND, central lymph node metastases, central compartment, recurrence-free survival. There was conflicting evidence regarding the rate of reoperation for recurrence, with some studies showing a lower rate after PND with increased recurrence-free survival and a higher rate of undetectable pre- and post-ablation thyroglobulin levels (LE 4), whereas other studies did not show a difference (LE 4). Only one study (LE 4) showed improved disease-specific survival with PND. PND may improve recurrence-free survival, although this is supported by only a low LE. Current recommendations can only be based on low-level evidence.

Published
2015

47. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

Author

UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, Coskun, H. Hakan, Medina, Jesus E., Robbins, K. Thomas, Silver, Carl E., Strojan, Primož, Teymoortash, Afshin, Pellitteri, Phillip K., Rodrigo, Juan P., Stoeckli, Sandro J., Shaha, Ashok R., Suárez, Carlos, Hartl, Dana M., De Bree, Remco, Takes, Robert P., Hamoir, Marc, Pitman, Karen T., Rinaldo, Alessandra, Ferlito, Alfio, UCL - (SLuc) Service d'oto-rhino-laryngologie, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, Coskun, H. Hakan, Medina, Jesus E., Robbins, K. Thomas, Silver, Carl E., Strojan, Primož, Teymoortash, Afshin, Pellitteri, Phillip K., Rodrigo, Juan P., Stoeckli, Sandro J., Shaha, Ashok R., Suárez, Carlos, Hartl, Dana M., De Bree, Remco, Takes, Robert P., Hamoir, Marc, Pitman, Karen T., Rinaldo, Alessandra, and Ferlito, Alfio

Abstract

Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.

Published
2015

49. The Prognosis of N2b and N2c Lymph Node Disease in Oral Squamous Cell Carcinoma Is Determined by the Number of Metastatic Lymph Nodes Rather Than Laterality

Author

Ebrahimi, Ardalan, Gil, Ziv, Amit, Moran, Yen, Tzu-Chen, Liao, Chun-Ta, Chaturvedi, Pankaj, Agarwal, Jai Prakash, Kowalski, Luiz P., Kohler, Hugo F., Kreppel, Matthias, Cernea, Claudio R., Brandao, Jose, Bachar, Gideon, Villaret, Andrea Bolzoni, Fliss, Dan, Fridman, Eran, Robbins, K. Thomas, Shah, Jatin P., Patel, Snehal G., Clark, Jonathan R., Ebrahimi, Ardalan, Gil, Ziv, Amit, Moran, Yen, Tzu-Chen, Liao, Chun-Ta, Chaturvedi, Pankaj, Agarwal, Jai Prakash, Kowalski, Luiz P., Kohler, Hugo F., Kreppel, Matthias, Cernea, Claudio R., Brandao, Jose, Bachar, Gideon, Villaret, Andrea Bolzoni, Fliss, Dan, Fridman, Eran, Robbins, K. Thomas, Shah, Jatin P., Patel, Snehal G., and Clark, Jonathan R.

Abstract

BACKGROUND: A study was conducted to assess for prognostic heterogeneity within the N2b and N2c classifications for oral cancer based on the number of metastatic lymph nodes and to determine whether laterality of neck disease provides additional prognostic information. METHODS: An international multicenter study of 3704 patients with oral cancer undergoing surgery with curative intent was performed. The endpoints of interest were disease-specific survival and overall survival. Model fit was assessed by the Akaike Information Criterion and comparison of models with and without the covariate of interest using a likelihood ratio test. RESULTS: The median number of metastatic lymph nodes was significantly higher in patients with N2c disease compared to those with N2b disease (P < .001). In multivariable analyses stratified by study center, the addition of the number of metastatic lymph nodes improved model fit beyond existing N classification. Next, the authors confirmed significant heterogeneity in prognosis based on the number of metastatic lymph nodes (<= 2, 3-4, and >= 5) in patients with both N2b and N2c disease (P < .001). A proposed reclassification combining N2b and N2c disease based on the number of metastatic lymph nodes demonstrated significant improvement in prognostic accuracy compared with the American Joint Committee on Cancer staging system, and no improvement was noted with the addition of a covariate for contralateral or bilateral neck disease (P = .472). CONCLUSIONS: The prognosis of patients with oral cancer with N2b and N2c disease appears to be similar after adequate adjustment for the burden of lymph node metastases, irrespective of laterality. Based on this finding, the authors propose a modified lymph node staging system that requires external validation before implementation in clinical practice. (C) 2014 American Cancer Society.

Published
2014

50. Radical neck dissection: is it still indicated?

Author

UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Hamoir, Marc, Silver, Carl E, Schmitz, Sandra, Takes, Robert P, Rinaldo, Alessandra, Rodrigo, Juan P, Robbins, K Thomas, Pitman, Karen T, Medina, Jesus E, Ferlito, Alfio, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Hamoir, Marc, Silver, Carl E, Schmitz, Sandra, Takes, Robert P, Rinaldo, Alessandra, Rodrigo, Juan P, Robbins, K Thomas, Pitman, Karen T, Medina, Jesus E, and Ferlito, Alfio

Published
2013

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