Preprint Article Version 1 This version is not peer-reviewed

Less is Enough: Outcome of Bimodality Definitive Concurrent Chemoradiation does not Differ from that of Trimodality Upfront Neck Dissection Followed by Adjuvant Treatment for >6 cm Bulky Lymph Node (N3) Head and Neck Cancer

Version 1 : Received: 26 March 2019 / Approved: 27 March 2019 / Online: 27 March 2019 (08:46:58 CET)

How to cite: Chen, W.; Chen, T.; Lai, S.; Liang, T.H.; Huang, B.; Wang, C. Less is Enough: Outcome of Bimodality Definitive Concurrent Chemoradiation does not Differ from that of Trimodality Upfront Neck Dissection Followed by Adjuvant Treatment for >6 cm Bulky Lymph Node (N3) Head and Neck Cancer. Preprints 2019, 2019030249 (doi: 10.20944/preprints201903.0249.v1). Chen, W.; Chen, T.; Lai, S.; Liang, T.H.; Huang, B.; Wang, C. Less is Enough: Outcome of Bimodality Definitive Concurrent Chemoradiation does not Differ from that of Trimodality Upfront Neck Dissection Followed by Adjuvant Treatment for >6 cm Bulky Lymph Node (N3) Head and Neck Cancer. Preprints 2019, 2019030249 (doi: 10.20944/preprints201903.0249.v1).

Abstract

Currently, data regarding optimal treatment modality, response, and outcome specifically for N3 head and neck cancer are lacking. This study aimed to compare the treatment outcomes between definitive concurrent chemoradiotherapy (CCRT) to the neck and upfront neck dissection followed by adjuvant CCRT. 93 N3 squamous cell carcinoma head and neck cancer patients were included. Primary tumor treatment was divided to definitive CCRT (CCRT group) or curative surgery followed by adjuvant CCRT (surgery group). Neck treatment was also classified into two treatment modalities: definitive CCRT to the neck (CCRT group) or curative neck dissection followed by adjuvant CCRT (neck dissection group). Overall, the 2-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 51.8%, 47.3%, 45.6%, and 43.6%, respectively. In both oropharyngeal cancer and nonoropharyngeal cancer patients, in terms of OS, LRFS, RRFS or DMFS no difference was noted regarding primary tumor treatment (CCRT vs. surgery) or neck treatment (CCRT vs. neck dissection). In summary, N3 neck patients treated with definitive CCRT can achieve similar outcomes to those treated with upfront neck dissection followed by adjuvant CCRT. Cautions should be made to avoid overtreatment for this group of patients.

Subject Areas

N3, head and neck cancer, radiation, upfront neck dissection, concurrent chemoradiotherapy

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