April 5, 2016
Image-guided surveillance may help detect the need for, and guidance of, neck dissection among patients with advanced nodal disease of the head and neck, avoiding the need for some posttreatment surgeries, according to a study published in the New England Journal of Medicine.
Researchers from the United Kingdom performed a prospective randomized controlled trial to assess the effectiveness of PET/CT-guided surveillance in the management of advanced (N2-N3) nodal disease of head and neck squamous cell carcinoma patients treated with primary chemoradiotherapy, in comparison to planned neck dissection. The PET/CT was performed 12 weeks after end of treatment with neck dissection done only if PET/CT showed incomplete or equivocal response. The co-primary endpoint was overall survival.
...The researchers concluded that PET/CT-guided surveillance demonstrated similar survival outcomes to planned neck dissections, but resulted in considerably fewer operations, fewer complications, and was more cost–effective.