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Selecting Patients for Planned Neck Dissection After Chemoradiotherapy in Regionally Advanced Head and Neck Cancer
Jai Prakash Agarwal, MD;
Indranil Mallick, MD, DNB;
Sarbani Ghosh-Laskar, MD, DNB;
Tejpal Gupta, MD, DNB;
Ashwini Budrukkar, MD, DNB;
Vedang Murthy, MD
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We thank Lau et al1 for presenting their experience with observation after a clinical complete response (CR) to radical chemoradiotherapy in regionally advanced head and neck cancer. The issue of neck dissection after a clinical CR has been a matter of contention. Several reports have presented data for and against planned neck dissection.
The need of the hour is to identify those patients who have the highest risk of subclinical residual disease despite a clinicoradiologic CR. Nodal diameter would be one of the most important predictive factors.2 It would also be a surrogate marker for tissue hypoxia, predicting a relative resistance to radiation therapy. Signs of extracapsular extension (ECE) on clinical or radiologic examination would be another important factor that may benefit from the removal of neck . . . [Full Text of this Article]
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