Publications [#178646] of Walter T Lee

Papers Published

1. SB Cannady, WT Lee, J Scharpf, RR Lorenz, BG Wood, M Strome, P Lavertu, RM Esclamado, JP Saxton, DJ Adelstein, Extent of neck dissection required after concurrent chemoradiation for stage IV head and neck squamous cell carcinoma., Head & neck, vol. 32 no. 3 (March, 2010), pp. 348-56, ISSN 1097-0347 [doi]
   (last updated on 2013/05/16)

   Abstract:
   BACKGROUND: The management of initially bulky nodal disease after primary nonsurgical treatment for stage IV head and neck squamous cell carcinoma (HNSCC) continues to be a subject of debate. METHODS: A retrospective chart review of neck management in patients after chemoradiation was performed. RESULTS: Of the initially positive necks analyzed, 210/329 (65%) had a complete clinical response to treatment and 161 necks underwent neck surgery. Patients were pathologically positive 13.8% and 39.6% of the time after clinical complete or partial response, respectively. Regional recurrence was more frequent in necks with partial clinical (p = .04) or pathologic responses (p < .01) and with primary site recurrences (p < .01). CONCLUSIONS: It is still safest at our institution to perform selective neck dissection on patients with > or = N2 neck disease when initially observed to prevent unsalvageable regional recurrence until more accurate interval assessment tools are confirmed.

   Keywords:
   Adult • Aged • Carcinoma, Squamous Cell • Chemotherapy, Adjuvant • Cohort Studies • Disease-Free Survival • Female • Head and Neck Neoplasms • Humans • Male • Middle Aged • Neck Dissection* • Neoplasm Recurrence, Local • Neoplasm Staging • Radiotherapy, Adjuvant • Retrospective Studies • Survival Rate • Young Adult • mortality • pathology* • prevention & control* • therapy*