Gallegos-Hernández JF, Abrego-Vázquez JA, Arias-Ceballos HA, Olvera-Casas A, Minauro-Muñoz GG, Ortiz-Maldonado AL, Hernández-San Juan M, García D

Language: Spanish
References: 17
Page: 47-52
PDF size: 204.56 Kb.

ABSTRACT

Background: Patients with bulky metastases of squamous cell carcinoma of the head and neck represent a challenge for the therapeutic decision; balance between oncological control and complications should be achieved. The therapeutic sequence has no impact on survival but it has on sequelae.
Objective: To know oncological results of patients with neck metastasis.
Material and Method: A retrospective analysis was done from 2009 to 2015 with patients undergoing treatment for cervical lymph node metastasis of squamous cell carcinoma. The therapeutic sequence was decided based on volume, resectability, site and size of the primary and general condition of the patient. Overall survival was calculated based on HPV status.
Results: There were 30 patients, 22 men and 8 women with a mean age of 57 years, 10 N3, and 20 N2. In 13 the HPV was positive, in 5 negative and in 12 the determination was not made. Seven patients were treated with initial chemotherapy and 23 underwent neck dissection; the 5-year survival was 25% and the prognosis was better in the positive HPV.
Conclusion: The treatment of cervical metastasis depends on its resectability; we should favor the initial surgery; the HPV is a factor of good prognosis.

REFERENCES

1. Gallegos-Hernández JF. El cáncer de cabeza y cuello. Factores de riesgo y prevención. Cir Ciruj 2006;74(4):287-293.

2. Gallegos-Hernández JF. Cervical lymph node metastases of squamous cell carcinoma from unknown primary. Current diagnostic and therapeutic approach. An Orl Mex 2016;61(1):57-65.

3. Elicin O, Albrecht T, Haynes AG, et al. Outcomes in advanced head and neck cancer treated with up-front neck dissection prior to (chemo)radiotherapy. Otolaryngol Head Neck Surg 2016 Feb;154(2):300-308.

4. Sanabria A, Silver C, Olsen DK, et al. Is elective neck dissection indicated during salvage surgery for head and neck squamous cell carcinoma? Arch Oto Rhino Laryngol 2014 Feb;271(12):3111-3119.

5. Van der Putten L, De Bree R, Kuik DJ, et al. Salvage laryngectomy: oncological and functional outcome. Oral Oncol 2011 Apr;47(4):296-301.

6. Strojan P, Ferlito A, Langendijk JA, et al. Contemporary management of lymph node metastases from an unknown primary to the neck II. A review of therapeutic options. Head Neck 2013 F eb;35(2):286-293.

7. Jouhi L, Halme E, Iriala H, et al. Epidemiological and treatment-related factors contribute to improved outcome of oropharyngeal squamous cell carcinoma in Finland. Acta Oncol 2018 Apr;57(4):541-551.

8. Flores-de la Torre C, Hernández-Hernández DM, Gallegos- Hernández JF. El virus del papiloma humano como factor pronóstico en pacientes con carcinoma epidermoide de cabeza y cuello. Cir Ciruj 2010;78:221-228.

9. Husain N, Neyaz A. Human papillomavirus associated head and neck squamous cell carcinoma: Controversies and new concepts. J Oral Biol Craniofac Res 2017 Sep- Dec;7(3):198-205.

10. Wopken K, Bijl HP, Langendijk JA. Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: A systematic review of literature. Radiother Oncol 2018 Jan;126(1):56-67.

11. Elicin O, Nisa L, Dal Pra A, et al. Up-front neck dissection followed by definitive (chemo)-radiotherapy in head and neck squamous cell carcinoma: Rationale, complications, toxicity rates and oncologic outcomes. A systematic review. Radiother Oncol 2016 May;119(2):185-193.

12. Patil VM, Prabhash K, Noronha V, et al. Neoadjuvant chemotherapy followed by surgery in very locally advanced technically unresectable oral cavity cancers. Oral Oncol 2014 Oct;50(10):1000-1004.

13. Liu H, Li J, Zhou Y, Hu Q, Zeng Y, Mohammadreza MM. Human papillomavirus as a favorable prognostic factor in a subset of head and neck squamous cell carcinomas: A meta-analysis. J Med Virol 2017 Apr;89(4):710-725.

14. Nevens D, Duprez F, Bonte K, et al. Upfront vs no upfront neck dissection in primary head and neck cancer rado (chemo) therapy: Tumor control and late toxicity. Radiother Oncol 2017 Aug;124(2):220-224.

15. Tangthongkum M, Kirtsreesakul V, Supanimitjaroenporn P Leelasawatsuk P. Treatment outcome of advance staged oral cavity cancer: concurrent chemo-radiotherapy compared with primary surgery. Eur Arch Otorhinolaryngol 2017 Jun;274(6):2567-2572.

16. Huguet F, Schick U, Pointreau Y. Role of induction chemotherapy in head and neck cancer. Cancer Radiother 2017 Oct;21(6.7):510-514.

17. Mehta V, Moore-Medlin T, Flores JM, Ma X, Ekshyyan O, Nathan CO. Survival outcomes based on systematic agent used concurrently with radiation in human-papillomavirus associated oropharyngeal cancer. Oncotarget 2017 Aug 10;8(41):70907-70915.