Management of neck metastases in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

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Management of neck metastases in head and neck cancer : United Kingdom National Multidisciplinary Guidelines. / Paleri, V.; Urbano, T. G.; Mehanna, H.; Repanos, C.; Lancaster, J.; Roques, T.; Patel, M.; Sen, M.

In: The Journal of laryngology and otology, Vol. 130, No. S2, 05.2016, p. S161-S169.

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Paleri, V. ; Urbano, T. G. ; Mehanna, H. ; Repanos, C. ; Lancaster, J. ; Roques, T. ; Patel, M. ; Sen, M. / Management of neck metastases in head and neck cancer : United Kingdom National Multidisciplinary Guidelines. In: The Journal of laryngology and otology. 2016 ; Vol. 130, No. S2. pp. S161-S169.

Bibtex

@article{78fda66820d849c38468655d5671084c,
title = "Management of neck metastases in head and neck cancer: United Kingdom National Multidisciplinary Guidelines",
abstract = "This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. A rational plan to manage the neck is necessary for all head and neck primaries. With the emergence of new level 1 evidence across several domains of neck metastases, this guideline will identify the evidence-based recommendations for management. Recommendations • Computed tomographic or magnetic resonance imaging is mandatory for staging neck disease, with choice of modality dependant on imaging modality used for the primary site, local availability and expertise. (R) • Patients with a clinically N0 neck, with more than 15-20 per cent risk of occult nodal metastases, should be offered prophylactic treatment of the neck. (R) • The treatment choice of for the N0 and N+ neck should be guided by the treatment to the primary site. (G) • If observation is planned for the N0 neck, this should be supplemented by regular ultrasonograms to ensure early detection. (R) • All patients with T1 and T2 oral cavity cancer and N0 neck should receive prophylactic neck treatment. (R) • Selective neck dissection (SND) is as effective as modified radical neck dissection for controlling regional disease in N0 necks for all primary sites. (R) • SND alone is adequate treatment for pN1 neck disease without adverse histological features. (R) • Post-operative radiation for adverse histologic features following SND confers control rates comparable with more extensive procedures. (R) • Adjuvant radiation following surgery for patients with adverse histological features improves regional control rates. (R) • Post-operative chemoradiation improves regional control in patients with extracapsular spread and/or microscopically involved surgical margins. (R) • Following chemoradiation therapy, complete responders who do not show evidence of active disease on co-registered positron emission tomography-computed tomography (PET-CT) scans performed at 10-12 weeks, do not need salvage neck dissection. (R) • Salvage surgery should be considered for those with incomplete or equivocal response of nodal disease on PET-CT. (R).",
author = "V. Paleri and Urbano, {T. G.} and H. Mehanna and C. Repanos and J. Lancaster and T. Roques and M. Patel and M. Sen",
year = "2016",
month = may,
doi = "10.1017/S002221511600058X",
language = "English",
volume = "130",
pages = "S161--S169",
journal = "The Journal of laryngology and otology",
issn = "0022-2151",
publisher = "Cambridge University Press",
number = "S2",

}

RIS

TY - JOUR

T1 - Management of neck metastases in head and neck cancer

T2 - United Kingdom National Multidisciplinary Guidelines

AU - Paleri, V.

AU - Urbano, T. G.

AU - Mehanna, H.

AU - Repanos, C.

AU - Lancaster, J.

AU - Roques, T.

AU - Patel, M.

AU - Sen, M.

PY - 2016/5

Y1 - 2016/5

N2 - This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. A rational plan to manage the neck is necessary for all head and neck primaries. With the emergence of new level 1 evidence across several domains of neck metastases, this guideline will identify the evidence-based recommendations for management. Recommendations • Computed tomographic or magnetic resonance imaging is mandatory for staging neck disease, with choice of modality dependant on imaging modality used for the primary site, local availability and expertise. (R) • Patients with a clinically N0 neck, with more than 15-20 per cent risk of occult nodal metastases, should be offered prophylactic treatment of the neck. (R) • The treatment choice of for the N0 and N+ neck should be guided by the treatment to the primary site. (G) • If observation is planned for the N0 neck, this should be supplemented by regular ultrasonograms to ensure early detection. (R) • All patients with T1 and T2 oral cavity cancer and N0 neck should receive prophylactic neck treatment. (R) • Selective neck dissection (SND) is as effective as modified radical neck dissection for controlling regional disease in N0 necks for all primary sites. (R) • SND alone is adequate treatment for pN1 neck disease without adverse histological features. (R) • Post-operative radiation for adverse histologic features following SND confers control rates comparable with more extensive procedures. (R) • Adjuvant radiation following surgery for patients with adverse histological features improves regional control rates. (R) • Post-operative chemoradiation improves regional control in patients with extracapsular spread and/or microscopically involved surgical margins. (R) • Following chemoradiation therapy, complete responders who do not show evidence of active disease on co-registered positron emission tomography-computed tomography (PET-CT) scans performed at 10-12 weeks, do not need salvage neck dissection. (R) • Salvage surgery should be considered for those with incomplete or equivocal response of nodal disease on PET-CT. (R).

AB - This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. A rational plan to manage the neck is necessary for all head and neck primaries. With the emergence of new level 1 evidence across several domains of neck metastases, this guideline will identify the evidence-based recommendations for management. Recommendations • Computed tomographic or magnetic resonance imaging is mandatory for staging neck disease, with choice of modality dependant on imaging modality used for the primary site, local availability and expertise. (R) • Patients with a clinically N0 neck, with more than 15-20 per cent risk of occult nodal metastases, should be offered prophylactic treatment of the neck. (R) • The treatment choice of for the N0 and N+ neck should be guided by the treatment to the primary site. (G) • If observation is planned for the N0 neck, this should be supplemented by regular ultrasonograms to ensure early detection. (R) • All patients with T1 and T2 oral cavity cancer and N0 neck should receive prophylactic neck treatment. (R) • Selective neck dissection (SND) is as effective as modified radical neck dissection for controlling regional disease in N0 necks for all primary sites. (R) • SND alone is adequate treatment for pN1 neck disease without adverse histological features. (R) • Post-operative radiation for adverse histologic features following SND confers control rates comparable with more extensive procedures. (R) • Adjuvant radiation following surgery for patients with adverse histological features improves regional control rates. (R) • Post-operative chemoradiation improves regional control in patients with extracapsular spread and/or microscopically involved surgical margins. (R) • Following chemoradiation therapy, complete responders who do not show evidence of active disease on co-registered positron emission tomography-computed tomography (PET-CT) scans performed at 10-12 weeks, do not need salvage neck dissection. (R) • Salvage surgery should be considered for those with incomplete or equivocal response of nodal disease on PET-CT. (R).

UR - http://www.scopus.com/inward/record.url?scp=85011952743&partnerID=8YFLogxK

U2 - 10.1017/S002221511600058X

DO - 10.1017/S002221511600058X

M3 - Article

C2 - 27841133

VL - 130

SP - S161-S169

JO - The Journal of laryngology and otology

JF - The Journal of laryngology and otology

SN - 0022-2151

IS - S2

ER -