Abstract
Recently, the use of chemoradiotherapy for preserving organs in the treatment of head and neck cancer is increasing. However, there is controversy about advanced neck node management in post-chemoradiation cases. We retrospectively analyzed our 119 cases of chemoradiotherapy for oropharyngeal and hypopharyngeal cancer to examine the effectiveness and indications of planned neck dissection.
Regional control rate and survival rate were superior in the neck dissection group. If the cases did not achieve CR in imaging, planned neck dissection improved the regional control rate significantly. We should perform planned neck dissection immediately rather than “wait and see” for this persistent disease.
However, in the cases achieving radiological CR, it is possible to omit planned neck dissection because of the high salvage rate of neck disease. However, in these cases, careful observation is essential.
We clarified that the presence of pathologically positive lymph node is a prognostic factor. For evaluating persistent disease of cervical lymph nodes, PET-CT was the most accurate method of imaging.
