Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy

Sjovall, Johanna, Chua, Benjamin, Pryor, David, Burmeister, Elizabeth, Foote, Matthew C., Panizza, Benedict, Burmeister, Bryan H. and Porceddu, Sandro V. (2015) Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy. Oral Oncology, 51 3: 260-266. doi:10.1016/j.oraloncology.2014.12.009


Author Sjovall, Johanna
Chua, Benjamin
Pryor, David
Burmeister, Elizabeth
Foote, Matthew C.
Panizza, Benedict
Burmeister, Bryan H.
Porceddu, Sandro V.
Title Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy
Journal name Oral Oncology   Check publisher's open access policy
ISSN 1879-0593
1368-8375
Publication date 2015-03-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.oraloncology.2014.12.009
Volume 51
Issue 3
Start page 260
End page 266
Total pages 7
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon Press
Collection year 2015
Language eng
Formatted abstract
Objectives

The current study presents the long-term results from a study designed to evaluate a restaging positron emission tomography (PET) directed policy whereby neck dissections were omitted in all node positive head and neck squamous cell carcinoma (N + HNSCC) patients with PET-negative lymph nodes after definitive radiotherapy (RT), with or without chemotherapy.

Methods

A post-therapy nodal response assessment with PET and computed tomography (CT) was performed in patients who achieved a complete response at the primary site after definitive radiotherapy. Patients with PET-negative lymph nodes were observed regardless of residual CT abnormalities.

Results

One hundred and twelve patients, the majority of whom (83 patients, 74%) had oropharyngeal primaries, were treated on protocol. Median follow-up was 62 months. Negative and positive predictive values for the restaging PET was 97.1% and 77.8% respectively, with only one patient who was PET-negative after treatment experiencing an isolated nodal relapse.

Conclusion

PET-guided management of the neck following organ preservation therapy effectively spares neck dissections in patients with N + HNSCC without compromising isolated nodal control or overall survival.
Keyword Head and neck
Squamous cell carcinoma
PET
Radiotherapy
Chemotherapy
Neck dissection
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 29 Dec 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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Created: Sat, 28 Feb 2015, 04:44:44 EST by Dr Benedict Panizza on behalf of Surgery - Princess Alexandra Hospital