The influence of excisional or incisional biopsy of metastatic neck nodes on the management of XXXX .

@entity1 @entity135 @entity66 @entity957 @entity3
Between November 1964 and December 1981, 80 @entity1 who had undergone an open biopsy of a cervical lymph node containing @entity957 were treated with curative intent in the University of Florida Division of Radiation Therapy. Irradiation was the initial step in the definitive treatment of all @entity1 , followed by neck dissection and/or primary resection, as indicated. The @entity1 were divided into two groups. (a) NX (no gross @entity135 ) (25 @entity1 ): According to the referring surgeons' and pathologists' reports, a single, clinically positive lymph node was totally excised in 25 @entity1 . No other clinically positive lymph nodes were appreciated upon referral. No neck dissections were added following irradiation in this group of @entity1 . The absolute 5 year disease-free survival in the NX group was 79%, and the rate of @entity135 control was 96%. (b) Gross @entity135 (55 @entity1 ): Gross residual disease remained in the neck in 55 @entity1 following biopsy. In some @entity1 , only an incisional biopsy of a large mass had been performed; in others, only one of several involved nodes was removed. The absolute 5 year disease-free survival in this group of @entity1 was 31%, and the rate of @entity135 control was 64%. The more consistent addition of a neck dissection in recent years has resulted in improved neck control rates in this group: 13/20 (65%) for N1-N2 disease and 2/7 (29%) for @entity66 following irradiation alone versus 6/7 (86%) for N2 disease and 5/8 (63%) for @entity66 when a neck dissection was added following irradiation. There are some differences in the rates of neck control, control above the clavicles, survival, distant @entity3 , and complications between this series and other reported series in which open neck-node biopsy preceded definitive treatment. Possible reasons for these differences are discussed.
