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Harold Lau, MD

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The issue of planned neck dissection after chemoradiation therapy for the N2-N3 neck remains a contentious issue. My colleagues and I recognize the limitations of our retrospective analysis. Nodal diameter was analyzed in our data, and it was not predictive of recurrence after chemoradiation therapy if the patient had a CR. Extracapsular extension was not analyzed, because our patient data set contained only patients diagnosed by fine-needle aspiration biopsy. Patients who underwent neck dissections or nodal excisions before chemoradiation therapy were excluded from our analysis. There were too few cases involving N3 disease (n = 5) in our cohort to comment on this patient group.

We agree that there is an urgent need to standardize radiologic criteria for assessing response after chemoradiation therapy. Currently, the most promising radiologic marker for CR is a negative result on fludeoxyglucose F 18 positron emission tomography. In a recent study published . . . [Full Text of this Article]

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