Selective versus @entity135 after chemoradiation for advanced XXXX .

@entity1 @entity135 @entity66 @entity957 @entity900 @entity189 @entity1487
OBJECTIVE: To determine whether a @entity135 ( @entity135 ) or a selective neck dissection (SND) is indicated as planned post-primary chemoradiation treatment (CRT) for @entity1 with advanced @entity957 ( @entity957 ). STUDY DESIGN: Case series with chart review. SETTING: A community teaching hospital. SUBJECTS: @entity1 with advanced @entity957 who received a uniform CRT protocol at Greater Baltimore Medical Center (GBMC). METHODS: Medical records of @entity1 treated with primary CRT for locoregionally advanced @entity957 at GBMC between 2001 and 2007 were reviewed. All @entity1 received 7000 to 7500, 6000, and 5000 cGy to primary disease sites, involved cervical lymphatics, and uninvolved cervical and supraclavicular lymphatics, respectively, with concomitant @entity900 (12 mg/m(2)/1 h) and @entity1487 (600 mg/m(2)/20 h) given on days one through five and 29 through 33. RESULTS: Seventy-six @entity1 received CRT, and 41 met the criteria for neck dissection. Forty-eight neck dissections were performed (34 unilateral and 7 bilateral), of which 23 (48%) were CNDs and 25 (52%) were SNDs. @entity189 was found in six (26%) of the @entity135 and five (20%) of the SND heminecks. The @entity135 group had six (26%) complications, whereas the SND group had two (8%). CONCLUSION: The high rate of @entity66 demonstrated in this study supports the need for post-CRT neck dissection. Although complication rates were not significantly different between the two groups, the trend in this study indicates that SND results in less morbidity. The presumed reduced morbidity and equivalent regional control rate suggest that SND is an appropriate surgical option for @entity957 @entity1 after primary CRT.
