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Article: Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: A clinicopathological study

TitleManagement of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: A clinicopathological study
Authors
Issue Date2001
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archoto.com
Citation
Archives Of Otolaryngology - Head And Neck Surgery, 2001, v. 127 n. 12, p. 1457-1462 How to Cite?
AbstractObjectives: To evaluate the efficacy of afterloading brachytherapy following radical neck dissection (RND) in the management of extensive cervical lymph node disease in nasopharyngeal carcinoma after radiotherapy; and to examine prospectively prognostic factors and the pathologic behavior of neck disease. Patients: Twenty-seven patients with nasopharyngeal carcinoma who had extensive cervical lymph node metastasis following external radiotherapy were treated with RND. Thirteen of them also underwent afterloading brachytherapy with iridium wire (Ir 192). The RND specimens of the 27 patients were also examined with step serial whole-specimen sectioning. Results: All patients survived and their wounds healed primarily. Pathologic examination revealed 183 tumorbearing lymph nodes that contained tumors in the neck: level I, 4% (8/183); level II, 53% (96/183); level III, 34% (62/183); level IV, 5% (9/183); and level V, 4% (8/183). Extracapsular tumor extension was seen in 84% of patients. Multivariate analysis identified the number of tumor-bearing lymph nodes detected in the specimens to be the only significant factor that affected control of disease. Although the neck disease in the group of patients who had afterloading brachytherapy was more extensive, the 3-year actuarial tumor control for the groups with and without brachytherapy were 60% and 61%, respectively. Conclusions: Recurrent cervical lymph nodes after radiotherapy in nasopharyngeal carcinoma are extensive and RND is mandatory for a successful salvage. When the nodal metastasis infiltrate or adhere to surrounding tissue, afterloading brachytherapy with iridium wire can provide satisfactory local tumor control.
Persistent Identifierhttp://hdl.handle.net/10722/88626
ISSN
2014 Impact Factor: 2.327
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWei, WIen_HK
dc.contributor.authorHo, WKen_HK
dc.contributor.authorCheng, ACKen_HK
dc.contributor.authorWu, Xen_HK
dc.contributor.authorLi, GKHen_HK
dc.contributor.authorNicholls, Jen_HK
dc.contributor.authorYuen, PWen_HK
dc.contributor.authorSham, JSTen_HK
dc.date.accessioned2010-09-06T09:45:51Z-
dc.date.available2010-09-06T09:45:51Z-
dc.date.issued2001en_HK
dc.identifier.citationArchives Of Otolaryngology - Head And Neck Surgery, 2001, v. 127 n. 12, p. 1457-1462en_HK
dc.identifier.issn0886-4470en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88626-
dc.description.abstractObjectives: To evaluate the efficacy of afterloading brachytherapy following radical neck dissection (RND) in the management of extensive cervical lymph node disease in nasopharyngeal carcinoma after radiotherapy; and to examine prospectively prognostic factors and the pathologic behavior of neck disease. Patients: Twenty-seven patients with nasopharyngeal carcinoma who had extensive cervical lymph node metastasis following external radiotherapy were treated with RND. Thirteen of them also underwent afterloading brachytherapy with iridium wire (Ir 192). The RND specimens of the 27 patients were also examined with step serial whole-specimen sectioning. Results: All patients survived and their wounds healed primarily. Pathologic examination revealed 183 tumorbearing lymph nodes that contained tumors in the neck: level I, 4% (8/183); level II, 53% (96/183); level III, 34% (62/183); level IV, 5% (9/183); and level V, 4% (8/183). Extracapsular tumor extension was seen in 84% of patients. Multivariate analysis identified the number of tumor-bearing lymph nodes detected in the specimens to be the only significant factor that affected control of disease. Although the neck disease in the group of patients who had afterloading brachytherapy was more extensive, the 3-year actuarial tumor control for the groups with and without brachytherapy were 60% and 61%, respectively. Conclusions: Recurrent cervical lymph nodes after radiotherapy in nasopharyngeal carcinoma are extensive and RND is mandatory for a successful salvage. When the nodal metastasis infiltrate or adhere to surrounding tissue, afterloading brachytherapy with iridium wire can provide satisfactory local tumor control.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archoto.comen_HK
dc.relation.ispartofArchives of Otolaryngology - Head and Neck Surgeryen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshBrachytherapyen_HK
dc.subject.meshCarcinoma - mortality - pathology - radiotherapy - therapyen_HK
dc.subject.meshCombined Modality Therapyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIridium Radioisotopes - therapeutic useen_HK
dc.subject.meshLymphatic Metastasisen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNasopharyngeal Neoplasms - mortality - pathology - radiotherapy - therapyen_HK
dc.subject.meshNecken_HK
dc.subject.meshNeck Dissectionen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshSurvival Rateen_HK
dc.titleManagement of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: A clinicopathological studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0886-4470&volume=127&issue=12&spage=1457&epage=1462&date=2001&atitle=Management+of+extensive+cervical+nodal+metastasis+in+nasopharyngeal+carcinoma+after+radiotherapy:+a+clinicopathological+studyen_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.emailNicholls, J: nicholls@pathology.hku.hken_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.identifier.authorityNicholls, J=rp00364en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11735814en_HK
dc.identifier.scopuseid_2-s2.0-0035215882en_HK
dc.identifier.hkuros66025en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035215882&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume127en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1457en_HK
dc.identifier.epage1462en_HK
dc.identifier.isiWOS:000172657600006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridHo, WK=7402968844en_HK
dc.identifier.scopusauthoridCheng, ACK=36055097300en_HK
dc.identifier.scopusauthoridWu, X=23101393300en_HK
dc.identifier.scopusauthoridLi, GKH=15034790200en_HK
dc.identifier.scopusauthoridNicholls, J=7201463077en_HK
dc.identifier.scopusauthoridYuen, PW=7103124007en_HK
dc.identifier.scopusauthoridSham, JST=24472255400en_HK

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