scholarly journals Necessity of Elective Neck Dissection in High Grade Parotid Cancer with Clinically Node Negative Neck: A Preliminary Study

2014 ◽  
Vol 25 (1) ◽  
pp. 44-48
Author(s):  
Seung Beom Son ◽  
Yeon Soo Kim ◽  
Jae Gu Cho ◽  
Jeong Soo Woo ◽  
Hwan Choe ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Elective Neck Dissection ◽  
High Grade ◽  
Node Negative ◽  
Parotid Cancer ◽  
Preliminary Study

scholarly journals Cost-effectiveness analysis of elective neck dissection in patients with clinically node negative oral cavity cancer.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e18275-e18275
Author(s):  
Joseph Roy Acevedo ◽  
Katherine Elaine Fero ◽  
Bayard R Wilson ◽  
Charles Coffey ◽  
James Don Murphy
Keyword(s):  
Cost Effectiveness ◽  
Oral Cavity ◽  
Neck Dissection ◽  
Oral Cavity Cancer ◽  
Cost Effectiveness Analysis ◽  
Elective Neck Dissection ◽  
Node Negative ◽  
Effectiveness Analysis

scholarly journals Management of the neck in malignant parotid neoplasm

2018 ◽  
Vol 5 (1) ◽  
pp. 236
Author(s):  
Ahmed Abdelwanis ◽  
Sowrav Barman
Keyword(s):  
Neck Dissection ◽  
Treatment Options ◽  
Lymphatic Invasion ◽  
Elective Neck Dissection ◽  
Malignant Neoplasms ◽  
Curative Intent ◽  
Parotid Cancer ◽  
Parotid Tumour ◽  
Parotid Neoplasm ◽  
Google Search

<p class="abstract">Parotid gland cancer (PGC) are rare and accounts for 3% of all head and neck malignancies.The classification of parotid tumour is complex and comprises both benign and malignant neoplasms of epithelial and non-epithelial origin.There is marked variation in the histological features of these tumours,therefore treatment options of parotid cancer is widely varied.Lymph node metastasis to the neck is one of the most important factors in therapy and prognosis for patients with parotid malignancy. This article reviews the literature regarding neck management of parotid cancer in cases of both clinically positive (cN+) and clinically negative (cN-) neck nodes. The literature search was performed using Google search engine, PUB Med to identify relevant articles on recommendations for neck management in patients with parotid cancer in cases of both clinically positive (cN+) and negative (cN-) neck nodes. Due to the rarity of parotid cancer and the wide histopathological varieties, the literature was hard to interpret. There is a consensus about managing clinically positive neck with therapeutic neck dissection. Most studies agree on elective neck dissection in certain indications which are high T stage, high grade histology, facial paralysis, age, extraglandular extension, peri-lymphatic invasion. Level II to IV appears to be at higher risk and can be done through the same parotidectomy incision. The role of irradiation in cN- necks is not clear but some studies recommend its usage for curative intent and argue that it adds less morbidity than the elective neck dissection. Although the management of the neck in cN+ patients is widely agreed, controversy still exists about the need for elective neck dissection in cN- patients and the levels which should be dissected.</p>

scholarly journals Elective Neck Dissection can Improve the Overall Survival and Cancer-Specific Survival of T3cN0M0 Glottic Squamous Cell Cancer

2021 ◽  
Author(s):  
Zhimou Cai ◽  
Lin Chen ◽  
Jiangwei Zhang ◽  
Yihui Wen ◽  
Wen-bin Lei
Keyword(s):  
Overall Survival ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Elective Neck Dissection ◽  
Cancer Specific Survival ◽  
Node Negative ◽  
Considerable Discussion

Abstract How to treat clinically node-negative (cN0) neck in larynx squamous cell cancer (LSCC) has been subject to considerable discussion. The role of elective neck dissection (END) in patients with T3 glottic squamous cell cancer (GSCC) with cN0 is remain unclear. The objective of this study is to elucidate the role of END in improve the outcome of T3cN0M0 GSCC. Patients with T3cN0M0 GSCC in the Surveillance, Epidemiology, and End Results database (SEER) from 2004 to 2015 were extracted and stratified into END and Non-END cohorts, we found that only 22–58% T3cN0M0 GSCC were performed with END. After Propensity score matching (PSM), END cohort had better overall survival (OS) (median survival time: 93 vs 40 months, respectively; p < 0.0001) and cancer-specific survival (CSS) (HR 0.40, 95%CI 0.26 to 0.64, p = 0.0012) than non-END cohort. In addition, Subgroup analysis also indicated END cohort had better OS or CSS than non-END cohort.This study demonstrated that in patients with T3cN0M0 GSCC, END significantly associated with better survival outcomes compared with non-END.

scholarly journals Is elective neck dissection necessary in cases of laryngeal recurrence after previous radiotherapy for early glottic cancer?

2014 ◽  
Vol 128 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
A Deganello ◽  
G Meccariello ◽  
B Bini ◽  
F Paiar ◽  
R Santoro ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Positive Node ◽  
Glottic Cancer ◽  
Elective Neck Dissection ◽  
Recurrent Tumour ◽  
Node Negative ◽  
Early Glottic Cancer ◽  
Node Positive ◽  
Laryngeal Surgery ◽  
Curative Radiotherapy

AbstractObjectives:To assess the clinical utility of elective neck dissection in node-negative recurrent laryngeal carcinoma after curative radiotherapy for initial early glottic cancer.Methods:A retrospective review was undertaken of 110 consecutive early glottic cancer patients who developed laryngeal recurrence after radiotherapy (34 recurrent T1, 36 recurrent T2, 29 recurrent T3 and 11 recurrent T4a) and received salvage laryngeal surgery between 1995 and 2005.Results:Six patients presented with laryngeal and neck recurrence and underwent salvage laryngectomy with therapeutic neck dissection, 97 patients with recurrent node-negative tumours underwent salvage laryngeal surgery without neck dissection and only 7 underwent elective neck dissection. No occult positive lymph nodes were documented in neck dissection specimens. During follow up, only three patients with neck failure were recorded, all in the group without neck dissection. There was no significant association between the irradiation field (larynx plus neck vs larynx) and the development of regional failure. A higher rate of post-operative pharyngocutaneous fistula development occurred in the neck dissection group than in the group without neck dissection (57.2 per cent vs 13.4 per cent, p = 0.01). Multivariate logistic regression analysis showed that early (recurrent tumour-positive, node-positive) or delayed (recurrent tumour-positive, node-negative) neck relapse was not significantly related to the stage of the initial tumour or the recurrent tumour. An age of less than 60 years was significantly associated with early neck failure (recurrent tumour-positive, node-positive).Conclusion:Owing to the low occult neck disease rate and high post-operative fistula rate, elective neck dissection is not recommended for recurrent node-negative laryngeal tumours after radiation therapy if the initial tumour was an early glottic cancer.

Parotid Cancer: Treatment and Results

1993 ◽  
Vol 72 (12) ◽  
pp. 787-793 ◽  
Author(s):  
David W. Roberson ◽  
Felix W. K. Chu ◽  
C. Thomas Yarington
Keyword(s):  
Radiation Therapy ◽  
Clinical Outcome ◽  
Neck Dissection ◽  
Residual Disease ◽  
Late Recurrence ◽  
Low Grade ◽  
High Grade ◽  
Parotid Cancer ◽  
High Incidence ◽  
Age And Sex

The records of 74 consecutive patients with primary parotid malignancy were reviewed. The age and sex incidence was comparable to that described in previous studies; we observed a high incidence of adenocarcinoma not reported by other investigators. Stage at the time of examination and histologic grade of tumor were independent statistically significant predictors of clinical outcome. Long survival with low grade disease and late recurrence were common. Radiation therapy has been shown to increase survival in a number of studies; however, it had no demonstrable benefit in our series. Parotid cancer should be managed aggressively and early surgery is indicated for all parotid neoplasms. Neck dissection is indicated for clinically positive nodes and high grade cancers; radiation therapy is indicated for high grade cancers and residual disease.

What is the role of elective neck dissection in low-, intermediate-, and high-grade mucoepidermoid carcinoma?

2015 ◽  
Vol 126 (1) ◽  
pp. 11-13 ◽  
Author(s):  
William J. Moss ◽  
Charles S. Coffey ◽  
Kevin T. Brumund ◽  
Robert A. Weisman
Keyword(s):  
Neck Dissection ◽  
Mucoepidermoid Carcinoma ◽  
Elective Neck Dissection ◽  
High Grade

scholarly journals Cost-Effectiveness Analysis of Elective Neck Dissection in Patients With Clinically Node-Negative Oral Cavity Cancer

2016 ◽  
Vol 34 (32) ◽  
pp. 3886-3891 ◽  
Author(s):  
Joseph R. Acevedo ◽  
Katherine E. Fero ◽  
Bayard Wilson ◽  
Assuntina G. Sacco ◽  
Loren K. Mell ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Oral Cavity ◽  
Neck Dissection ◽  
Oral Cavity Cancer ◽  
Early Stage ◽  
Cost Effective ◽  
Disease Recurrence ◽  
Elective Neck Dissection ◽  
Node Negative ◽  
Primary Surgery

Purpose Recently, a large randomized trial found a survival advantage among patients who received elective neck dissection in conjunction with primary surgery for clinically node-negative oral cavity cancer compared with those receiving primary surgery alone. However, elective neck dissection comes with greater upfront cost and patient morbidity. We present a cost-effectiveness analysis of elective neck dissection for the initial surgical management of early-stage oral cavity cancer. Methods We constructed a Markov model to simulate primary, adjuvant, and salvage therapy; disease recurrence; and survival in patients with T1/T2 clinically node-negative oral cavity squamous cell carcinoma. Transition probabilities were derived from clinical trial data; costs (in 2015 US dollars) and health utilities were estimated from the literature. Incremental cost-effectiveness ratios, expressed as dollar per quality-adjusted life-year (QALY), were calculated with incremental cost-effectiveness ratios less than $100,000/QALY considered cost effective. We conducted one-way and probabilistic sensitivity analyses to examine model uncertainty. Results Our base-case model found that over a lifetime the addition of elective neck dissection to primary surgery reduced overall costs by $6,000 and improved effectiveness by 0.42 QALYs compared with primary surgery alone. The decrease in overall cost despite the added neck dissection was a result of less use of salvage therapy. On one-way sensitivity analysis, the model was most sensitive to assumptions about disease recurrence, survival, and the health utility reduction from a neck dissection. Probabilistic sensitivity analysis found that treatment with elective neck dissection was cost effective 76% of the time at a willingness-to-pay threshold of $100,000/QALY. Conclusion Our study found that the addition of elective neck dissection reduces costs and improves health outcomes, making this a cost-effective treatment strategy for patients with early-stage oral cavity cancer.

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