Postoperative radiotherapy in head and neck squamous cell cancers: AIIMS experience

16514 Background: Squamous cell cancers of the head and neck are one of the most common malignancies in India. Most patients present in advanced stages of disease. Postoperative radiotherapy is generally an integral part of management in these patients. Methods: Patients of head and neck squamous cell cancers treated with surgery and postoperative radiotherapy at AIIMS between January 1999 to December 2004 were retrospectively analyzed. Results: A total of 386 patients were treated of which 281 were available for evaluation. There were 233 males and 48 females. Median age was 46 years (range 18–73). Site-wise distribution was: oral cavity- 202, larynx-55, hypopharynx-14, paranasal sinus-4, oropharynx-4, neck nodes with unknown primary-2. Post-surgical margins were adequate in 241, close in 5 (2%) and positive in 35 (12%). Pathological stage grouping was: Stage I- 11(4%), Stage II- 52 (18%), Stage III- 63(22%), Stage IV- 155 (55%). Neck node dissection was done in 245 patients and nodes were pathologically negative in 119 (42%). Extracapsular extension (ECE) was seen in 19(7%) patients. Bone/cartilage invasion was seen in 62(22%). Patients with high risk features (close/positive margins, ECE, 4/> positive nodes) were prescribed a dose of 64 Gy while the rest were planned to receive 60 Gy. 85% of patients completed the intended course of radiation. At a median follow up of 37 months, local recurrences were seen in 28 (10%), regional recurrence in 25 (9%) and distant metastasis in 10 (4%) patients. A second malignant neoplasm occurred in 6 patients (3-oropharynx, 2-oral cavity, 1-lung). Disease free survival (DFS) was 68%. ECE, post-surgical margin status and pathological lymph node status were significantly associated with DFS. Duration of postoperative radiotherapy and the surgery to radiotherapy interval did not significantly affect DFS. Conclusions: ECE, postsurgical margin status and pathological lymph node status significantly impact DFS in patients of surgically treated squamous cell cancers of head and neck. These patients require doses of adjuvant radiation >/=64 Gy. No significant financial relationships to disclose.

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Prognostic Value of Lymph Node Status Is Greater Than Lymph Node Ratio and AJCC N Staging for Head and Neck Squamous Cell Carcinomas

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2015.12.140 ◽

2016 ◽

Vol 94 (4) ◽

pp. 911-912

Author(s):

T. Roberts ◽

A.D. Colevas ◽

W. Hara ◽

F.C. Holsinger ◽

I. Oakley-Girvan ◽

...

Keyword(s):

Lymph Node ◽

Head And Neck ◽

Squamous Cell ◽

Prognostic Value ◽

Lymph Node Ratio ◽

Squamous Cell Carcinomas ◽

Lymph Node Status ◽

Node Status ◽

Node Ratio ◽

N Staging

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A robust and interpretable gene signature for predicting the lymph node status of primary T1 / T2 oral cavity squamous cell carcinoma

International Journal of Cancer ◽

10.1002/ijc.33828 ◽

2021 ◽

Author(s):

Yasmin Ghantous ◽

Mohamed Omar ◽

Esther Channah Broner ◽

Nishant Agrawal ◽

Alexander T. Pearson ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Gene Signature ◽

Lymph Node Status ◽

Node Status

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The lymph node status and histologic subtypes influenced the effect of postoperative radiotherapy on patients with N2 positive IIIA non-small cell lung cancer

Journal of Surgical Oncology ◽

10.1002/jso.25308 ◽

2018 ◽

Cited By ~ 2

Author(s):

Chongze Yuan ◽

Xiaoting Tao ◽

Difan Zheng ◽

Yunjian Pan ◽

Ting Ye ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Postoperative Radiotherapy ◽

Small Cell ◽

Lymph Node Status ◽

Small Cell Lung ◽

Node Status ◽

Histologic Subtypes

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Lymph node status assessment in head and neck squamous cell carcinoma in patients with clinically non palpable lymph nodes: Meta-analysis

QJM ◽

10.1093/qjmed/hcab094.009 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hany Riad ◽

Samer Ibrahim ◽

Amr Gouda ◽

Ossama Mustafa ◽

Heba Mohamed

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Meta Analysis ◽

Lymph Node Status ◽

Lymph Node Staging ◽

Pet Ct

Abstract Background The most important prognostic factor in squamous cell carcinoma of the head and neck (HNSCC) is the presence or absence of clinically involved neck nodes. The presence of metastases in a lymph node is said to reduce the 5-years survival rate by about 50%. The appropriate diagnosis of the presence of metastatic node is very important for the management of HNSCC Aim To compare difTerent diagnostic modalities for assessment of the clinically non palpable lymph nodes in HNSCC including by meta-analysis: CT, MRI, US, USFNAC and PET/CT for the proper cervical lymph node staging. Methods Met-analysis study on patients with HNSCC of clinically non palpable lymph nodes (cN0). Results Analysis was divided in 6 groups .Each group contain analysis of one modality according to available studies per patient, per level and per lesion .US is fair test per patient and per lesion.CT is good test per patient and excellent test per lesion.MRI is poor test per patient and fair test per lesion.CT-MRl combined is fair per patient and excellent per level.PET/CT is good per patient, fair per lesion and excellent per level. USFNAC is excellent per lesion. Conclusion CT, CT-MRI combined, PET/CT and USFNAC proved to be excellent in detecting cN0.MRI was poor test in detecting cN0.US was a fair test in detecting cN0 if used alone.

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Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

PLoS ONE ◽

10.1371/journal.pone.0239783 ◽

2020 ◽

Vol 15 (9) ◽

pp. e0239783

Author(s):

Inger-Heidi Bjerkli ◽

Helene Laurvik ◽

Elisabeth Sivy Nginamau ◽

Tine M. Søland ◽

Daniela Costea ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tongue Squamous Cell Carcinoma ◽

Tumor Budding ◽

Lymph Node Status ◽

Pathology Report ◽

Oral Tongue ◽

Node Status

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Lymph node status in extracranial head and neck cancers: Lymph node microdissection versus dynamic CT

Clinical Radiology ◽

10.1016/s0009-9260(05)81334-0 ◽

1993 ◽

Vol 48 (5) ◽

pp. 344-345

Author(s):

G.T. Abbott ◽

J.F.M. Meaney ◽

H.G. Lewis-Jones ◽

J. Woolgar ◽

S. Kearney ◽

...

Keyword(s):

Lymph Node ◽

Head And Neck ◽

Head And Neck Cancers ◽

Lymph Node Status ◽

Dynamic Ct ◽

Node Status

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Comparative analysis of clinical and pathological lymph node staging data in head and neck squamous cell carcinoma patients treated at the General Hospital Vienna

Radiology and Oncology ◽

10.2478/raon-2018-0020 ◽

2018 ◽

Vol 52 (2) ◽

pp. 173-180 ◽

Cited By ~ 1

Author(s):

Christina Eder-Czembirek ◽

Birgit Erlacher ◽

Dietmar Thurnher ◽

Boban M. Erovic ◽

Edgar Selzer ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Head And Neck ◽

Correlation Coefficient ◽

Squamous Cell ◽

Neck Squamous Cell Carcinoma ◽

Clinical Staging ◽

Lymph Node Status ◽

Lymph Node Staging

Abstract Background Results from publications evaluating discrepancies between clinical staging data in relation to pathological findings demonstrate that a significant number of head and neck squamous cell carcinoma (HNSCC) patients are not correctly staged. The aim of this retrospective study was to analyze potential discrepancies of radiological assessment versus pathological data of regional lymph node involvement and to compare the results with data published in the literature. Patients and methods In a retrospective analysis we focused on patients with HNSCC routinely treated by surgery plus postoperative radiotherapy between 2002 and 2012. For inclusion, complete pre-operative clinical staging information with lymph node status and patho-histological information on involved lymph node regions as well as survival outcome data were mandatory. We included 87 patients (UICC stage III-IV 90.8%) for which the aforementioned data obtained by CT or MRI were available. Overall survival rates were estimated by the Kaplan–Meier method. The Pearson correlation coefficient and Spearman’s rank correlation coefficient (non-linear relationship) was calculated. Results Discrepancies at the level of overall tumour stage assessment were noticed in 27.5% of all cases. Thereof, 5.7% were assigned to patho-histological up-staging or down-staging of the primary tumour. At the lymph node level, 11.5% of the patients were downstaged, and 10.3% were upstaged. Conclusions The study showed that in approximately one-fifth (21.8%) of the patients, lymph node assessment by CT or MRI differs from the pathologic staging, an outcome that corresponds well with those published by several other groups in this field.

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Associations of Polymorphisms Localized in the 3′UTR Regions of the KRAS, NRAS, MAPK1 Genes with Laryngeal Squamous Cell Carcinoma

Genes ◽

10.3390/genes12111679 ◽

2021 ◽

Vol 12 (11) ◽

pp. 1679

Author(s):

Ruta Insodaite ◽

Alina Smalinskiene ◽

Vykintas Liutkevicius ◽

Virgilijus Ulozas ◽

Roberta Poceviciute ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Squamous Cell ◽

Distant Metastasis ◽

Laryngeal Squamous Cell Carcinoma ◽

Positive Lymph Node ◽

Lymph Node Status ◽

Node Status ◽

Positive Lymph Node Status

Background: Genetic variations, localized in the 3′ untranslated region (UTR) in mitogen-activated protein kinase (MAPK) pathway-related genes, may alter the transcription and impact the pathogenesis of laryngeal squamous cell carcinoma (LSCC). The present study investigated the associations of single-nucleotide polymorphisms (SNP), localized in the 3′UTR) of the KRAS, NRAS, and MAPK1 genes with LSCC risk and clinicopathological features. Methods: Genomic DNA and clinical data were collected from 327 adult men with LSCC. The control group was formed from 333 healthy men. Genotyping of the SNPs was performed using TaqMan SNP genotyping assays. Five KRAS, NRAS, and MAPK1 polymorphisms were analyzed. All studied genotypes were in Hardy–Weinberg equilibrium and had the same allele distribution as the 1000 Genomes project Phase 3 dataset for the European population. Results: Significant associations of the studied SNPs with reduced LSCC risk were observed between NRAS rs14804 major genotype CC. Significant associations of the studied SNPs with clinicopathologic variables were also observed between NRAS rs14804 minor T allele and advanced tumor stage and positive lymph node status. SNP of MAPK1 rs9340 was associated with distant metastasis. Moreover, haplotype analysis of two KRAS SNPs rs712 and rs7973450 revealed that TG haplotype was associated with positive lymph node status in LSCC patients. Conclusions: According to the present study, 3′UTR SNP in the NRAS and MAPK1 genes may contribute to the identifications of patients at higher risk of LSCC lymph node and distant metastasis development.

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