Consensus on resectability in N3 head and neck squamous cell carcinomas: GETTEC recommendations.

Cervical nodes Chemoradiation Contraindication Head and neck squamous cell carcinoma Neck dissection Surgery

Journal

Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118

Informations de publication

Date de publication:
07 2020
Historique:
received: 17 04 2020
accepted: 20 04 2020
pubmed: 27 4 2020
medline: 17 2 2021
entrez: 27 4 2020
Statut: ppublish

Résumé

Among patients with T0-2 N3 head and neck squamous cell carcinomas (HNSCC), those undergoing upfront neck dissection have better oncological outcomes. However, there is no consensual definition of disease resectability of N3 nodes, leading to major treatment attrition and interpretation biases between studies. We established a Delphi method-based consensus to define resectability and impact on decision-making for upfront neck dissection in N3 patients. The Delphi method was designed as recommended by the French Haute Autorite de Sante among head and neck surgeons from university hospitals and cancer centers, using a 24-item questionnaire. Strong and relative agreements were subsequently established, and recommendations were written. The resulting recommendations were assessed by 30 independent surgeons. N3 nodes with intraparenchymal brain invasion, foramen invasion, skull base erosion, nodes requiring bilateral XII Consensual contraindications to neck dissection in patients with T0-2 N3 HNSCC were defined among French head and neck surgeons as concerns skull base invasion, retropharyngeal nodes and bilateral XII

Sections du résumé

BACKGROUND
Among patients with T0-2 N3 head and neck squamous cell carcinomas (HNSCC), those undergoing upfront neck dissection have better oncological outcomes. However, there is no consensual definition of disease resectability of N3 nodes, leading to major treatment attrition and interpretation biases between studies. We established a Delphi method-based consensus to define resectability and impact on decision-making for upfront neck dissection in N3 patients.
METHODS
The Delphi method was designed as recommended by the French Haute Autorite de Sante among head and neck surgeons from university hospitals and cancer centers, using a 24-item questionnaire. Strong and relative agreements were subsequently established, and recommendations were written. The resulting recommendations were assessed by 30 independent surgeons.
RESULTS
N3 nodes with intraparenchymal brain invasion, foramen invasion, skull base erosion, nodes requiring bilateral XII
CONCLUSION
Consensual contraindications to neck dissection in patients with T0-2 N3 HNSCC were defined among French head and neck surgeons as concerns skull base invasion, retropharyngeal nodes and bilateral XII

Identifiants

pubmed: 32335323
pii: S1368-8375(20)30169-X
doi: 10.1016/j.oraloncology.2020.104733
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104733

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Florent Carsuzaa (F)

Head and Neck Surgery, University Hospital of Poitiers, France.

Philippe Gorphe (P)

Department of Head and Neck Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France.

Sébastien Vergez (S)

Institut Universitaire du Cancer de Toulouse Oncopole, University Hospital of Toulouse, France.

Olivier Malard (O)

Head and Neck Surgery, University Hospital of Nantes, France.

Nicolas Fakhry (N)

Head and Neck Surgery, APHM, La Conception University Hospital, Marseille, France.

Christian Righini (C)

Head and Neck Surgery, University Hospital of Grenoble, France.

Pierre Philouze (P)

Head and Neck Surgery, Croix Rousse Hospital, Hospices Civils de Lyon (Hospital Group of Lyon), France.

Audrey Lasne-Cardon (A)

Head and Neck Surgery, Centre François Baclesse, Caen, France.

Patrice Gallet (P)

Head and Neck Surgery, University Hospital of Nancy, France.

Denis Tonnerre (D)

Head and Neck Surgery, University Hospital of Poitiers, France.

Alexandre Bozec (A)

Head and Neck Surgery, Institut Universitaire de la Face et du Cou, Nice, France.

Erwan de Mones (E)

Head and Neck Surgery, University Hospital of Bordeaux, France.

Bertrand Baujat (B)

Head and Neck Surgery, Tenon Hospital, Paris, France.

Laurent Laccourreye (L)

Head and Neck Surgery, University Hospital of Angers, France.

Emmanuel Babin (E)

Head and Neck Surgery, Centre François Baclesse, Caen, France.

Xavier Dufour (X)

Head and Neck Surgery, University Hospital of Poitiers, France.

Juliette Thariat (J)

Radiation Oncology, Centre François Baclesse/ARCHADE, Caen, France. Electronic address: jthariat@gmail.com.

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Classifications MeSH