| Neck dissection after chemoradiotherapy: timing and complications. | |
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MedLine Citation:
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PMID: 21079159 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine the incidence of postchemoradiotherapy (post-CRT) neck dissection (ND) complications; to ascertain whether timing (< 12 vs ≥ 12 weeks) from CRT to ND or other factors are associated with increased complications; and to determine whether ND timing influences disease control or survival. DESIGN: Ten-year retrospective analysis. SETTING: Tertiary care center. PATIENTS: One hundred five patients with head and neck cancer undergoing ND after CRT. MAIN OUTCOME MEASURES: Complications and survival variables compared between groups undergoing ND less than 12 weeks (less-than-12-weeks ND group) and 12 weeks or more (12-weeks-or-more ND group) after CRT. RESULTS: Sixty-seven NDs were performed less than 12 weeks and 38 were performed 12 weeks or more after CRT. Patient characteristics, treatment, and ND pathology results were comparable between the 2 ND groups. The incidence of complications between the less-than-12-weeks and the 12-weeks-or-more ND groups included major wound complications in 8 of 67 (11.9%) vs 1 of 38 (2.6%; P = .15), minor wound complications in 11 of 67 (16.4%) vs 4 of 38 (10.5%; P = .56), airway complications in 7 of 67 (10.4%) vs 2 of 38 (5.3%; P = .48), and systemic complications in 9 of 67 (13.4%) vs 2 of 38 (5.3%; P = .32). The number of patients with at least 1 complication was significantly smaller in the 12-weeks-or-more ND group (P = .04). Multivariate analysis showed that radical ND was significantly associated with an increased number of complications, and higher radiation doses approached significance (P = .05). Induction chemotherapy was associated with fewer wound complications (P = .01). There were no significant differences in overall survival (P = .82), progression-free survival (P = .77), or regional relapse (P = .54) between groups. Positive ND findings were associated with diminished progression-free and overall survival. CONCLUSION: These findings indicate that ND can be safely performed 12 weeks or more after CRT without adversely affecting surgical complications or survival variables. |
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Authors:
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Laura A Goguen; Claudia I Chapuy; Yi Li; Sihai D Zhao; Donald J Annino |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of otolaryngology--head & neck surgery Volume: 136 ISSN: 1538-361X ISO Abbreviation: Arch. Otolaryngol. Head Neck Surg. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-16 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8603209 Medline TA: Arch Otolaryngol Head Neck Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1071-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Otolaryngology, Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. lgoguen@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carcinoma, Squamous Cell / drug therapy, pathology, radiotherapy, surgery* Combined Modality Therapy Female Head and Neck Neoplasms / drug therapy, pathology, radiotherapy, surgery* Humans Lymphatic Metastasis Male Middle Aged Neck Dissection / methods* Postoperative Complications Proportional Hazards Models Regression Analysis Retrospective Studies Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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