TY - JOUR
T1 - Planned neck dissection after chemoradiotherapy in advanced oropharyngeal squamous cell cancer
T2 - The role of US, MRI and FDG-PET/TC scans to assess residual neck disease
AU - Pellini, Raul
AU - Manciocco, Valentina
AU - Turri-Zanoni, Mario
AU - Vidiri, Antonello
AU - Sanguineti, Giuseppe
AU - Marucci, Laura
AU - Sciuto, Rosa
AU - Covello, Renato
AU - Sperduti, Isabella
AU - Kayal, Ramy
AU - Anelli, Vincenzo
AU - Pichi, Barbara
AU - Mercante, Giuseppe
AU - Spriano, Giuseppe
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Objective To investigate the ability of neck ultrasounds (US), magnetic resonance imaging (MRI) and positron emission tomography (FDG-PET/TC) in detecting residual nodal disease after chemoradiotherapy in patients with advanced oropharyngeal squamous cell carcinoma (OPSCC).Methods From 2006 to 2009, 36 consecutive patients affected by OPSCC with bulky nodal disease (>3 cm), treated with primary concurrent chemoradiotherapy, were enrolled prospectively. Nodal response to treatment was assessed by using US, MRI and FDG-PET/CT. Planned neck dissection (ND) was performed in all the patients, and the histopathological node status was compared to the imaging findings in order to establish sensitivity, specificity, accuracy and predictive values of each technique.Results Metastatic disease was assessed in 18/37 (48.6%) hemi-necks, always localized in levels II-IV. US showed greater sensitivity (77.8%) and, combined with FDG-PET/TC, produced the highest negative predictive value (93.3%). US, MRI and FDG-PET/TC scans showed the highest specificity (100%), accuracy (93.8%) and positive predictive values (100%).Conclusions In the presence of advanced OPSCC with bulky nodal disease, US combined with FDG-PET/TC could be a reliable and cost-effective strategy to identify patients with complete nodal response to chemoradiotherapy that might not require post-treatment ND but only observation. When residual disease in the neck was detected, selective ND was recommended.
AB - Objective To investigate the ability of neck ultrasounds (US), magnetic resonance imaging (MRI) and positron emission tomography (FDG-PET/TC) in detecting residual nodal disease after chemoradiotherapy in patients with advanced oropharyngeal squamous cell carcinoma (OPSCC).Methods From 2006 to 2009, 36 consecutive patients affected by OPSCC with bulky nodal disease (>3 cm), treated with primary concurrent chemoradiotherapy, were enrolled prospectively. Nodal response to treatment was assessed by using US, MRI and FDG-PET/CT. Planned neck dissection (ND) was performed in all the patients, and the histopathological node status was compared to the imaging findings in order to establish sensitivity, specificity, accuracy and predictive values of each technique.Results Metastatic disease was assessed in 18/37 (48.6%) hemi-necks, always localized in levels II-IV. US showed greater sensitivity (77.8%) and, combined with FDG-PET/TC, produced the highest negative predictive value (93.3%). US, MRI and FDG-PET/TC scans showed the highest specificity (100%), accuracy (93.8%) and positive predictive values (100%).Conclusions In the presence of advanced OPSCC with bulky nodal disease, US combined with FDG-PET/TC could be a reliable and cost-effective strategy to identify patients with complete nodal response to chemoradiotherapy that might not require post-treatment ND but only observation. When residual disease in the neck was detected, selective ND was recommended.
KW - Chemoradiotherapy
KW - FDG-PET-CT
KW - Neck ultrasound
KW - Oropharyngeal cancer
KW - Planned neck dissection
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U2 - 10.1016/j.jcms.2014.06.023
DO - 10.1016/j.jcms.2014.06.023
M3 - Article
C2 - 25150165
AN - SCOPUS:84924031462
VL - 42
SP - 1834
EP - 1839
JO - Journal of Maxillofacial Surgery
JF - Journal of Maxillofacial Surgery
SN - 1010-5182
IS - 8
ER -