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

Author

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
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8. Standardization for oncologic head and neck surgery

Author

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
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10. 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

13. 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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15. Management of the Neck in Well-Differentiated Thyroid Cancer

Author

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

Published
2021
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16. 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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17. 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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18. 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

19. 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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20. 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

21. 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

22. 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

23. 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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26. 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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27. Cervical Lymph Node Metastasis in Adenoid Cystic Carcinoma of the Larynx: A Collective International Review

Author

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

Published
2016
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28. Cervical Lymph Node Metastasis in High-Grade Transformation of Head and Neck Adenoid Cystic Carcinoma: A Collective International Review

Author

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

Published
2016
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34. Nasal cavity and paranasal sinus

Author

Pai, Prathamesh S., primary, Ghosh Laskar, Sarbani, additional, Kane, Shubhada, additional, Robbins, K. Thomas, additional, Nicolai, Piero, additional, and Licitra, Lisa, additional

Published
2015
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40. 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

41. 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

42. 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

43. 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

44. 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

47. Contemporary management of the neck in nasopharyngeal carcinoma

Author

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

Published
2021
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49. 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

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