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Topics:
Head and Neck Cancers • Radiation Oncology
What is the role of up-front neck dissection in locally advanced head and neck squamous cell carcinoma?
Specifically, what arguments can be made for or against upfront neck dissection in patients who present with necrotic neck nodes? How would the outcome of neck dissection affect subsequent management (adjuvant RT, adjuvant chemo-RT, coverage, dose etc.)
Answer from: Radiation Oncologist at Community Practice
The place of neck dissection (whether performed before or after definitive chemoradiotherapy) in the treatment of advanced head and neck cancer continues to be debated, with wide institutional variability in practice. Prior to this recent randomized trial from the UK published in the NEJM (N Engl J...
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Answer from: Radiation Oncologist at Academic Institution
Upfront neck dissection should preferably be used as part of definitive surgery for both the neck and the primary tumor, especially when surgery is expected to result in very good tumor control rates and functional results, such as in small-medium T stage oropharyngeal cances. In the case of multipl...