Cancers (May 2021)
Impact of Neck Dissection in Head and Neck Squamous Cell Carcinomas of Unknown Primary
- Yazan Abu-Shama,
- Julia Salleron,
- Florent Carsuzaa,
- Xu-Shan Sun,
- Carole Pflumio,
- Idriss Troussier,
- Claire Petit,
- Matthieu Caubet,
- Arnaud Beddok,
- Valentin Calugaru,
- Stephanie Servagi-Vernat,
- Joël Castelli,
- Jessica Miroir,
- Marco Krengli,
- Paul Giraud,
- Edouard Romano,
- Jonathan Khalifa,
- Mélanie Doré,
- Nicolas Blanchard,
- Alexandre Coutte,
- Charles Dupin,
- Shakeel Sumodhee,
- Yungan Tao,
- Vincent Roth,
- Lionel Geoffrois,
- Bruno Toussaint,
- Duc Trung Nguyen,
- Jean-Christophe Faivre,
- Juliette Thariat
Affiliations
- Yazan Abu-Shama
- Department of Oto-Rhino-Laryngology—Head and Neck Surgery, Centre Hospitalier Régional Universitaire, Vandœuvre-Lès-Nancy, 54519 Nancy, France
- Julia Salleron
- Department of Biostatistics and Data Management, Institut de Cancérologie de Lorraine, 54519 Nancy, France
- Florent Carsuzaa
- Department of Oto-Rhino-Laryngology—Head and Neck Surgery, Centre Hospitalier Régional Universitaire, 86021 Poitiers, France
- Xu-Shan Sun
- Department of Radiotherapy, CHRU de Besançon—Montbéliard, 25000 Besançon, France
- Carole Pflumio
- Department of Oncology, Institut de Cancérologie de Lorraine, 54519 Nancy, France
- Idriss Troussier
- Centre des Hautes Energies, Department of Radiotherapy, 06000 Nice, France
- Claire Petit
- Department of Radiotherapy, Institut Gustave Roussy, 94805 Villejuif, France
- Matthieu Caubet
- Department of Radiotherapy, CHRU de Besançon—Montbéliard, 25000 Besançon, France
- Arnaud Beddok
- Department of Radiotherapy, Institut Curie, 75005 Paris, France
- Valentin Calugaru
- Department of Radiotherapy, Institut Curie, 75005 Paris, France
- Stephanie Servagi-Vernat
- Department of Radiotherapy, Institut Jean Godinot, 51100 Reims, France
- Joël Castelli
- Department of Radiotherapy, Institut Eugène Marquis, 35000 Rennes, France
- Jessica Miroir
- Centre Jean Perrin, Department of Radiotherapy, 63011 Clermont-Ferrand, France
- Marco Krengli
- Department of Radiotherapy, University of Piemonte Orientale, 27100 Pavia, Italy
- Paul Giraud
- Department of Radiotherapy, Centre Hospitalier Universitaire Tenon—Assistance Publique–Hôpitaux de Paris, 75020 Paris, France
- Edouard Romano
- Department of Radiotherapy, Centre Hospitalier Universitaire Tenon—Assistance Publique–Hôpitaux de Paris, 75020 Paris, France
- Jonathan Khalifa
- Department of Radiotherapy, Institut Universitaire du Cancer, 31100 Toulouse, France
- Mélanie Doré
- Department of Radiotherapy, Institut de Cancérologie de l’Ouest, 44800 Nantes, France
- Nicolas Blanchard
- Department of Radiotherapy, Clinique les Dentellières, 59300 Valenciennes, France
- Alexandre Coutte
- Department of Radiotherapy, Centre Hospitalier Universitaire d’Amiens, 80000 Amiens, France
- Charles Dupin
- Department of Radiotherapy, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France
- Shakeel Sumodhee
- Centre Antoine Lacassagne, Department of Radiotherapy, 06000 Nice, France
- Yungan Tao
- Centre des Hautes Energies, Department of Radiotherapy, 06000 Nice, France
- Vincent Roth
- Easy CRF, 8 Rue Lecourtois, 14920 Mathieu, France
- Lionel Geoffrois
- Department of Oncology, Institut de Cancérologie de Lorraine, 54519 Nancy, France
- Bruno Toussaint
- Department of Oto-Rhino-Laryngology—Head and Neck Surgery, Centre Hospitalier Régional Universitaire, Vandœuvre-Lès-Nancy, 54519 Nancy, France
- Duc Trung Nguyen
- Department of Oto-Rhino-Laryngology—Head and Neck Surgery, Centre Hospitalier Régional Universitaire, Vandœuvre-Lès-Nancy, 54519 Nancy, France
- Jean-Christophe Faivre
- Department of Radiotherapy, Institut de Cancérologie de Lorraine, 54519 Nancy, France
- Juliette Thariat
- Centre François Baclesse—Centre de Recherche Avancées d’Hadronthérapie Européenne, Department of Radiotherapy, University of Caen Normandie, 14000 Caen, France
- DOI
- https://doi.org/10.3390/cancers13102416
- Journal volume & issue
-
Vol. 13,
no. 10
p. 2416
Abstract
Purpose: Management of head and neck cancers of unknown primary (HNCUP) combines neck dissection (ND) and radiotherapy, with or without chemotherapy. The prognostic value of ND has hardly been studied in HNCUP. Methods: A retrospective multicentric study assessed the impact of ND extent (adenectomy, selective ND, radical/radical-modified ND) on nodal relapse, progression-free survival (PFS) or survival, taking into account nodal stage. Results: 53 patients (16.5%) had no ND, 33 (10.2%) had lymphadenectomy, 116 (36.0%) underwent selective ND and 120 underwent radical/radical-modified ND (37.3%), 15 of which received radical ND (4.7%). With a 34-month median follow-up, the 3-year incidence of nodal relapse was 12.5% and progression-free survival (PFS) 69.1%. In multivariate analysis after adjusting for nodal stage, the risk of nodal relapse or progression was reduced with lymphadenectomy, selective or radical/modified ND, but survival rates were similar. Patients undergoing lymphadenectomy or ND had a better PFS and lowered nodal relapse incidence in the N1 + N2a group, but the improvement was not significant for the N2b or N2 + N3c patients. Severe toxicity rates exceeded 40% with radical ND. Conclusion: In HNCUP, ND improves PFS, regardless of nodal stage. The magnitude of the benefit of ND does not appear to depend on ND extent and decreases with a more advanced nodal stage.
Keywords
- neoplasms/cancers/carcinomas
- head and neck
- unknown primary
- neck dissection
- chemoradiotherapy
- prognosis