Importance: The inclusion of data about the presence of metastatic neck nodes with extracapsular spread (ECS) in the neck dissection improves the prognostic classification of patients with head and neck squamous cell carcinoma (HNSCC).
Objective: To evaluate the prognostic capacity of ECS in patients with HNSCC, and to analyze the usefulness of including this information in the pathological classification of patients treated with a neck dissection.
Design: Retrospective unicenter study performed from 1985 through 2007.
Setting: Tertiary referral center.
Participants: A total of 1190 patients with HNSCC treated with a neck dissection.
Intervention: Unilateral or bilateral neck dissection .
Main Outcomes And Measures: Adjusted survival and local, regional, and distant metastases-free survival. Patients were classified according to a recursive partitioning analysis (RPA) method, considering pN category and number of neck nodes with ECS as the independent variables.
Results: Five-year adjusted survival for patients without metastatic nodes in the neck dissection (pN0) was 85.5%, for patients with neck node metastases without ECS (pN+/ECS-) it was 62.5%, and for patients with neck node metastases with ECS (pN+/ECS+) it was 29.9%. There were significant differences in survival between patients with pN0 lesions and pN+/ECS- (P < .001), and between patients with pN+/ECS- and those with pN+/ECS+ (P < .001). According to the RPA method, we propose classifying patients according to 4 categories: category I, pN0 lesions; category II, pN1/ECS+ or pN+/ECS-; category III, pN2-3/1 node and ECS+; and category IV, pN2-3/2 or more nodes and ECS+. The RPA-derived classification achieved a better prognostic discrimination than the pTNM classification.
Conclusions And Relevance: The inclusion of information about ECS in the neck dissection improved the prognostic classification of patients with HNSCC in relation to the pTNM classification.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/jamaoto.2013.2666 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Will the autofluorescence take over inadvertent parathyroidectomy? Results from a multicentre cohort study.
Updates Surg
January 2025
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
Background: Recently, several devices exploiting the near-infrared autofluorescence (NIR-AF) of parathyroid glands (PGs) have been developed. Nevertheless, their impact on both preserving PGs from inadvertent surgical dissection and on post-surgical hypoparathyroidism (hypoPTH) is controversial.
Methods: A retrospective study of 845 patients undergoing thyroid surgery in 2 academic tertiary centres was conducted.
Unusual Presentation of Papillary Thyroid Carcinoma as a Lateral Neck Cystic Mass: A Case Report.
Cureus
December 2024
General Surgery, King Fahad Specialist Hospital, Buraydah, SAU.
Papillary thyroid cancer (PTC) is the most frequent thyroid malignancy. Recently, the incidence has become widespread among both male and female individuals worldwide. In this article, we aim to report a 32-year-old Saudi female who presented with a painless lateral neck mass for more than seven months, and on excisional biopsy, was found to have features of PTC.
View Article and Find Full Text PDFPreoperative approach and technical considerations in parotid surgery.
Gland Surg
December 2024
Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Comprehensive Cancer Center-Jefferson Health Asplundh Cancer Pavilion, Willow Grove, PA, USA.
Various approaches and techniques have been developed to address parotid neoplasms over the years. This article reflects on the integration, modification, and refinement of these techniques over a decade of clinical practice. This article provides a narrative description of the evolution of a head and neck oncologic surgeon's approach to parotid neoplasms.
View Article and Find Full Text PDFPrediction model construction of cervical central lymph node metastasis in papillary thyroid carcinoma combined with Hashimoto's thyroiditis utilizing conventional ultrasound and elastography.
Gland Surg
December 2024
Department of Ultrasound, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China.
Background: When papillary thyroid carcinoma (PTC) is accompanied by Hashimoto's thyroiditis (HT), it is often challenging for preoperative ultrasound to distinguish between central lymph node enlargement caused by PTC metastasis and inflammatory reaction due to HT. However, central lymph node metastasis (CLNM) is closely associated with the risk of PTC recurrence after surgery. In this study, we developed a model to predict in patients with PTC combined with HT, based on conventional ultrasound characteristics and shear wave elastography (SWE) quantitative parameters of the primary lesion.
View Article and Find Full Text PDFMulticenter Retrospective Analysis of Pediatric Differentiated Thyroid Carcinoma: Treatment Practices and Outcomes Prior to Pediatric American Thyroid Association Guidelines Implementation.
Pediatr Blood Cancer
January 2025
Division of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas, USA.
Background: Differentiated thyroid carcinoma (DTC) is the most common pediatric thyroid malignancy, with papillary thyroid carcinoma (PTC) representing 90% of the cases. In 2015, the American Thyroid Association (ATA) developed management guidelines for pediatric DTC.
Procedure: Patients less than 21 years of age diagnosed with DTC between 2000 and 2015 at Texas Children's Hospital, Seattle Children's Hospital, Children's Healthcare of Atlanta, Children's Hospital Colorado, and Nationwide Children's Hospital were retrospectively analyzed to evaluate treatment practices before the implementation of the ATA guidelines.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!