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Article: Extracapsular lymph node spread in recurrent nasopharyngeal carcinoma

TitleExtracapsular lymph node spread in recurrent nasopharyngeal carcinoma
Authors
Keywordsbrachytherapy
extracapsular spread
nodal tumor control
Recurrent nasopharyngeal carcinoma
survival
Issue Date2011
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/
Citation
Laryngoscope, 2011, v. 121 n. 12, p. 2576-2580 How to Cite?
AbstractObjectives/Hypothesis: To study the efficacy of combined neck dissection and brachytherapy for nodal metastasis with extracapsular spread (ECS) in recurrent nasopharyngeal carcinoma (NPC). Study Design: Prospective. Methods: Between 1990 and 2010, we recruited patients who had regional recurrent NPC after radiotherapy. The prevalence of ECS, the type of treatments, and the postoperative complications were noted. Nodal tumor control and disease-free survival were compared between patients with or without ECS. Results: Macroscopic ECS was seen in 25.9% of our series of 158 patients. They were treated by extended radical neck dissection (RND) followed by brachytherapy. The rest of the patients without ECS were treated by RND alone. Median follow-up duration was 62 months. With such aggressive treatment, there was no significant difference in the 5-year actuarial nodal control (62% and 65%, P =.18) and 5-year disease-free survival (38% and 44%, P =.08) between those with or without ECS. Regional flaps were employed (deltopectoral flap: 24 patients; pectoralis major flap: 17 patients) to prevent wound necrosis and carotid blowout after brachytherapy. The rate of delayed vagal and hypoglossal nerve palsy after brachytherapy was 2.4% and 4.8%, respectively. None of our patients developed cerebral ischemia secondary to accelerated atherosclerosis from brachytherapy after previous external radiotherapy. Conclusions: With combined surgery and brachytherapy, satisfactory results can be achieved in patients with ECS in recurrent NPC. Reconstruction with regional flaps is mandatory to prevent serious complications like wound necrosis and carotid artery blowout. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/144589
ISSN
2015 Impact Factor: 2.272
2015 SCImago Journal Rankings: 1.342
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, YWen_HK
dc.contributor.authorLee, VHFen_HK
dc.contributor.authorChow, VLYen_HK
dc.contributor.authorTo, VSHen_HK
dc.contributor.authorWei, WIen_HK
dc.date.accessioned2012-02-03T06:15:04Z-
dc.date.available2012-02-03T06:15:04Z-
dc.date.issued2011en_HK
dc.identifier.citationLaryngoscope, 2011, v. 121 n. 12, p. 2576-2580en_HK
dc.identifier.issn0023-852Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/144589-
dc.description.abstractObjectives/Hypothesis: To study the efficacy of combined neck dissection and brachytherapy for nodal metastasis with extracapsular spread (ECS) in recurrent nasopharyngeal carcinoma (NPC). Study Design: Prospective. Methods: Between 1990 and 2010, we recruited patients who had regional recurrent NPC after radiotherapy. The prevalence of ECS, the type of treatments, and the postoperative complications were noted. Nodal tumor control and disease-free survival were compared between patients with or without ECS. Results: Macroscopic ECS was seen in 25.9% of our series of 158 patients. They were treated by extended radical neck dissection (RND) followed by brachytherapy. The rest of the patients without ECS were treated by RND alone. Median follow-up duration was 62 months. With such aggressive treatment, there was no significant difference in the 5-year actuarial nodal control (62% and 65%, P =.18) and 5-year disease-free survival (38% and 44%, P =.08) between those with or without ECS. Regional flaps were employed (deltopectoral flap: 24 patients; pectoralis major flap: 17 patients) to prevent wound necrosis and carotid blowout after brachytherapy. The rate of delayed vagal and hypoglossal nerve palsy after brachytherapy was 2.4% and 4.8%, respectively. None of our patients developed cerebral ischemia secondary to accelerated atherosclerosis from brachytherapy after previous external radiotherapy. Conclusions: With combined surgery and brachytherapy, satisfactory results can be achieved in patients with ECS in recurrent NPC. Reconstruction with regional flaps is mandatory to prevent serious complications like wound necrosis and carotid artery blowout. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/en_HK
dc.relation.ispartofLaryngoscopeen_HK
dc.subjectbrachytherapyen_HK
dc.subjectextracapsular spreaden_HK
dc.subjectnodal tumor controlen_HK
dc.subjectRecurrent nasopharyngeal carcinomaen_HK
dc.subjectsurvivalen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshBiopsy, Needleen_HK
dc.subject.meshBrachytherapy - methodsen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshCombined Modality Therapyen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHead and Neck Neoplasms - mortality - pathology - therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunohistochemistryen_HK
dc.subject.meshLymph Node Excision - methodsen_HK
dc.subject.meshLymph Nodes - pathologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNasopharyngeal Neoplasms - mortality - pathology - therapyen_HK
dc.subject.meshNeck Dissection - methodsen_HK
dc.subject.meshNeoplasm Invasiveness - pathologyen_HK
dc.subject.meshNeoplasm Recurrence, Local - mortality - pathology - therapyen_HK
dc.subject.meshNeoplasm Stagingen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshRisk Assessmenten_HK
dc.subject.meshSurvival Analysisen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleExtracapsular lymph node spread in recurrent nasopharyngeal carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.emailChan, YW: jywchan1@hku.hken_HK
dc.identifier.emailFun Lee, VH: vhflee@hkucc.hku.hken_HK
dc.identifier.emailHowe To, VS: doctorto@hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.authorityChan, YW=rp01314en_HK
dc.identifier.authorityLee, VHF=rp00264en_HK
dc.identifier.authorityTo, VSH=rp01385en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/lary.22380en_HK
dc.identifier.pmid22113918-
dc.identifier.scopuseid_2-s2.0-82155197308en_HK
dc.identifier.hkuros198326en_US
dc.identifier.hkuros210288-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-82155197308&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume121en_HK
dc.identifier.issue12en_HK
dc.identifier.spage2576en_HK
dc.identifier.epage2580en_HK
dc.identifier.eissn1531-4995-
dc.identifier.isiWOS:000297644000013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, YW=27171772200en_HK
dc.identifier.scopusauthoridFun Lee, VH=14035860900en_HK
dc.identifier.scopusauthoridYu Chow, VL=37462593200en_HK
dc.identifier.scopusauthoridHowe To, VS=35957345400en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK

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