Peng Hanwei, Wang Steven J, Yang Xihong, Lin Jianying, Guo Haipeng, Liu Muyuan
Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou City, Guangdong Province 515031, China.
Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, 2233 Post St, 3rd Floor, San Francisco, CA 94115, United States.
Auris Nasus Larynx. 2014 Oct;41(5):485-90. doi: 10.1016/j.anl.2014.05.018. Epub 2014 Jun 10.
Although radical neck dissection is proposed as a standard salvage procedure for the management of radiotherapy-resistant nasopharyngeal carcinoma of the neck, modified radical neck dissection may be appropriate for select patients. This study was designed to evaluate the efficacy of individualized neck dissections based on preoperative imaging studies and intraoperative exploration for the management of radiotherapy-resistant nasopharyngeal carcinoma of the neck.
The study included 42 consecutive patients who failed radiotherapy or chemo-radiotherapy for nasopharyngeal carcinoma of the neck and underwent a total of 46 radical neck dissections or modified radical neck dissections. Selection of the proper type of neck dissection was based on preoperative imaging studies and intraoperative exploration. The patients' clinical features, pathologic characteristics, complications, and treatment outcome were estimated and analyzed.
Radical neck dissection and modified radical neck dissection were performed on 19 and 27 necks, respectively. Thirty-three necks (71.7%) had multiple node metastases. Nineteen necks (41.3%) had node metastases at two or more levels. The overall morbidity rate was 11.9%. The 5-year neck control rate (NCR) was 79.1% for 46 necks. The 5-year overall survival and disease free survival for 42 patients were 58.0% and 44.0%, respectively. No statistically significant differences were found in comparing OS, DFS, NCR between the MRND and RND groups.
Individualized neck dissection based on preoperative imaging studies and intraoperative exploration is appropriate for the management of radiotherapy-resistant nasopharyngeal carcinoma of the neck.
