Viable Tumor in Postchemoradiation Neck Dissection Specimens As an Indicator of Poor Outcome

Overview

Journal Head Neck

Specialties General Surgery
Oncology

Date 2011 Sep 20

PMID 21928410

Citations 8

Authors

Ian Ganly

Jennifer Bocker

Diane L Carlson

Salvatore DArpa

Maria Coleman

Nancy Lee

David G Pfister

Jatin P Shah

Snehal G Patel

Affiliations

Soon will be listed here.

Abstract

Background: The objective of this study was to determine the prognostic significance of viable tumor in postchemoradiation neck dissection specimens in patients with squamous cell carcinoma of the laryngopharynx.

Methods: Retrospective analysis identified 181 patients treated with primary concurrent chemoradiation for carcinoma of the laryngopharynx at Memorial Sloan-Kettering Cancer Center between the years 1995 and 2005. Of these, 56 patients had a comprehensive neck dissection either as a planned or salvage procedure. Neck dissection specimens were analyzed by a single pathologist for the presence of viable tumor. The presence of viable tumor was correlated to the timing of neck dissection after chemoradiation and to tumor response. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were determined by the Kaplan-Meier method, and correlation to tumor viability was determined with the log-rank test.

Results: Nineteen (33%) patients had viable tumor in their neck dissection specimens. Viable tumor was higher in patients who had a less-than-complete response to chemoradiation compared with those who had a complete response (42% vs 25%, p = .1). There was no correlation to timing of neck dissection. The 5-year OS, DSS, and RFS were significantly lower in patients who had viable tumor in their neck dissection specimens (OS 49% vs 93%, p = .0005; DSS 56% versus 93%, p = .003; RFS 40% vs 75%, p = .004).

Conclusions: Patients with viable tumor in postchemoradiation neck dissection specimens had a poorer outcome compared with patients with no viable tumor.

Citing Articles

Usefulness of Upfront Neck Dissection Before Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma.

Okada T, Ueda Y, Okamoto I, Sato H, Tokashiki K, Kondo T In Vivo. 2024; 38(6):2804-2811.

PMID: 39477387 PMC: 11535927. DOI: 10.21873/invivo.13760.

Histopathological Analysis of Nodal Disease After Chemoradiation Reveals Viable Tumor Cells as the most Important Prognostic Factor in Head and Neck Squamous Cell Carcinoma.

Golliez A, Morand G, Broglie M, Balermpas P, Rupp N Head Neck Pathol. 2023; 17(3):599-606.

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[Follow-up ultrasound of head and neck cancer].

Kunzel J, Bozzato A, Strieth S HNO. 2017; 65(11):939-952.

PMID: 28905170 DOI: 10.1007/s00106-017-0411-3.

Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129.

Galloway T, Zhang Q, Nguyen-Tan P, Rosenthal D, Soulieres D, Fortin A Int J Radiat Oncol Biol Phys. 2016; 96(2):362-371.

PMID: 27478170 PMC: 5078986. DOI: 10.1016/j.ijrobp.2016.05.026.

Complete pathologic response as a prognostic factor for squamous cell carcinoma of the oropharynx post-chemoradiotherapy.

Trufelli D, Matos L, Santana T, Capelli F, Kanda J, Del Giglio A Braz J Otorhinolaryngol. 2015; 81(5):498-504.

PMID: 26277829 PMC: 9449043. DOI: 10.1016/j.bjorl.2015.07.009.

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