Authors: R Maquieira S K Haerle G F Huber A Soltermann S R Haile S J Stoeckli Martina A Broglie
Publish Date: 2015/06/10
Volume: 273, Issue: 7, Pages: 1841-1848
Abstract
The aim of the study was to assess regional control and survival in primary irradiated oropharyngeal cancer patients with advanced neck disease ≥cN2a receiving planned neck dissection PND irrespective of the nodal response compared to salvage neck dissection SND in case of regional persistence or reccurence in relation to tumoral p16 overexpression 96 consecutive patients treated at the University Hospital of Zurich Switzerland were included Tissue microarraybased scoring of p16 expression was obtained 5 years overall OS and diseasespecific survival DSS in the PND and SND cohort were 70 vs 57 p = 020 and 80 vs 65 p = 014 respectively Regional control in PND and SND achieved 95 vs 87 p = 029 respectively There was no statistically significant impact of neck treatment PND vs SND on regional control or survival among patients with p16negative tumors 5 years OS 59 vs 50 p = 066 5 years DSS 59 vs 57 p = 089 nor among patients with p16positive tumors 5 years OS 84 vs 67 p = 021 5 years DSS 95 vs 81 p = 024 The type of neck dissection after primary intensitymodulated radiotherapy IMRT had no impact on regional control and survival even in human papillomavirus HPVassociated disease Therefore we are convinced that based on the accuracy of newer diagnostic modalities the surveillance of a radiologically negative neck after primary chemoradiation CRT is oncologically safe irrespective of p16 expression of the tumorThe study protocol obtained approval by the local Ethics Committee and all procedures were in accordance with the ethical standards of the Helsinki Declaration of 1975 as revised in 1983 For this retrospective data analysis formal consent was not required
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