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Prognostic significance of extracapsular spread in isolated neck recurrences in head and neck squamous cell carcinoma patients

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Abstract

Few studies have analyzed the appearance of extracapsular spread (ECS) in salvage neck dissections carried out after regional recurrence of the disease. The aim of our study was to evaluate the frequency of ECS in patients with an isolated regional recurrence treated with a salvage neck dissection, and to assess the influence of ECS on prognosis. We conducted a retrospective study of 123 patients treated with a salvage neck dissection. Eighty-two patients (66.7 %) had nodes with ECS. Five-year salvage-specific survival for patients without ECS was 77.2 %, whereas for patients with ECS it was 32.0 % (P = 0.0001). According to the results of a multivariate analysis, the presence of ECS in the salvage neck dissection was the only variable significantly related to the salvage-specific survival. Sixty-six percent of the patients with nodes with ECS had adjuvant treatment with radiotherapy or chemoradiotherapy. Five-year salvage-specific survival for patients with ECS who had not received adjuvant treatment (n = 26) was 15.2 %, whereas for patients treated with adjuvant radiotherapy (n = 39) or chemotherapy (n = 17), 5-year salvage-specific survival was 36.4 and 47.1 %, respectively. Patients with ECS could benefit from adjuvant treatment with radiotherapy or chemoradiotherapy.

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Acknowledgments

The authors thank Luis León and Orla Condren for editorial support.

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Authors and Affiliations

  1. Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain

    Xavier León, Antoni Rigó, Montserrat López, Jacinto García, Julia de Juan & Miquel Quer

  2. Radiation Oncology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    Nuria Farré

  3. Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain

    Xavier León

Authors
  1. Xavier León
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  2. Antoni Rigó
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  3. Nuria Farré
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  4. Montserrat López
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  5. Jacinto García
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  6. Julia de Juan
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  7. Miquel Quer
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Corresponding author

Correspondence to Xavier León.

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Funding

This study was supported by a grant from the Instituto de Salud Carlos III (FIS PI14/01918). Fondo Europeo de Desarrollo Regional (FEDER), A Way to Build Europe.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Due to the retrospective type of the study no formal consent was required.

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León, X., Rigó, A., Farré, N. et al. Prognostic significance of extracapsular spread in isolated neck recurrences in head and neck squamous cell carcinoma patients. Eur Arch Otorhinolaryngol 274, 527–533 (2017). https://doi.org/10.1007/s00405-016-4249-1

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  • DOI: https://doi.org/10.1007/s00405-016-4249-1

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