For resected oral cavity squamous cell carcinoma with indication for adjuvant radiotherapy to the primary tumor bed, would you routinely include ipsilateral and/or contralateral nodes even with a pN0 elective neck dissection?
Does it vary based on tumor site (oral tongue, FOM, gingiva, hard palate, etc.)?
Answer from: Radiation Oncologist at Academic Institution
Since the question states "routinely", the short answer is yes, but the longer answer is there is much more nuance to this.Some will say no based on Contreras et al., PMID 31246526.It is important though to recognize that this paper is a bit more complex and the details are critical.The question ref...
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Radiation Oncologist at Icahn School of Medicine at Mount Sinai Agree with this approach.
Additionally, our insti...
Answer from: Radiation Oncologist at Academic Institution
I don't think we are ready for complete omission of the pN0 neck, however, in cases with a well-lateralized tumor such as gingiva and oral tongue, I will omit a contralateral cN0 or pN0 neck. This has to be carefully considered on a case-by-case basis and involves discussion with the patient.
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Radiation Oncologist at Slidell Memorial Regional Cancer Center With oral tongue being a “midline structure&...
Answer from: Radiation Oncologist at Academic Institution
We have been selectively omitting RT to the pN0 neck for the last few years at George Washington University, based on this study by Contreras et al., PMID 31246526. This is regardless of the risk factors at the primary tumor site. Additionally, if the ipsilateral neck RT is omitted due to pN0, we ha...
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Radiation Oncologist at White Plains Hospital Ganly et al., PMID 23184439
Radiation Oncologist at Emory University School of Medicine I generally agree with Dr. @Rao's points here, but...
Radiation Oncologist at Hawaii Pacific Oncology Center If a free flap was used for closure of the primary...
Agree with this approach. Additionally, our insti...