Contralateral neck metastases in lateralised, resectable advanced stage oropharyngeal squamous cell carcinoma—Results of 57 patients undergoing bilateral selective neck dissection

Contralateral neck metastases in lateralised, resectable advanced stage oropharyngeal squamous... KeypointsThis series demonstrates unique data assessing the surgical staging of the cN0 contralateral neck in lateralised oropharyngeal squamous cell carcinoma.Only 5 of 57 patients were found to have occult nodal metastases. The rate appears to be higher in HPV‐negative disease (3/5 patients) than HPV‐positive patients (2/52 patients)This multidepartmental policy in the management of resectable oropharyngeal squamous cell carcinoma led to the reduction in adjuvant radiotherapy field in 52 patients and appropriate intensification of adjuvant therapy in 5 patients.The contralateral neck in these patients needs managing or staging, if avoidance of prophylactic radiotherapy is deemed desirable. Surgical staging seems appropriate, but given the low incidence of occult metastases, other options would include preoperative 18F‐FDG PET/CT staging, serial imaging, sentinel lymph node biopsy or delivery of adjuvant treatment unilaterally following routine staging imaging.Decisions on which approach is most appropriate should be made by individual MDT's, whilst consensus is lacking.INTRODUCTIONManagement of the clinically N0 contralateral neck has long been a contentious issue in the management of oropharyngeal squamous cell carcinoma (OPSCC). The work of Lim et al established the value of electively treating the N0 contralateral neck in patients with OPSCC, particularly to include levels II‐IV, rather than I‐III. There is also http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Otolaryngology Wiley

Contralateral neck metastases in lateralised, resectable advanced stage oropharyngeal squamous cell carcinoma—Results of 57 patients undergoing bilateral selective neck dissection

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Publisher
Wiley
Copyright
© 2018 John Wiley & Sons Ltd
ISSN
1749-4478
eISSN
1749-4486
D.O.I.
10.1111/coa.13040
Publisher site
See Article on Publisher Site

Abstract

KeypointsThis series demonstrates unique data assessing the surgical staging of the cN0 contralateral neck in lateralised oropharyngeal squamous cell carcinoma.Only 5 of 57 patients were found to have occult nodal metastases. The rate appears to be higher in HPV‐negative disease (3/5 patients) than HPV‐positive patients (2/52 patients)This multidepartmental policy in the management of resectable oropharyngeal squamous cell carcinoma led to the reduction in adjuvant radiotherapy field in 52 patients and appropriate intensification of adjuvant therapy in 5 patients.The contralateral neck in these patients needs managing or staging, if avoidance of prophylactic radiotherapy is deemed desirable. Surgical staging seems appropriate, but given the low incidence of occult metastases, other options would include preoperative 18F‐FDG PET/CT staging, serial imaging, sentinel lymph node biopsy or delivery of adjuvant treatment unilaterally following routine staging imaging.Decisions on which approach is most appropriate should be made by individual MDT's, whilst consensus is lacking.INTRODUCTIONManagement of the clinically N0 contralateral neck has long been a contentious issue in the management of oropharyngeal squamous cell carcinoma (OPSCC). The work of Lim et al established the value of electively treating the N0 contralateral neck in patients with OPSCC, particularly to include levels II‐IV, rather than I‐III. There is also

Journal

Clinical OtolaryngologyWiley

Published: Jan 1, 2018

References

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