Metástasis cervicales de carcinoma epidermoide de cabeza y cuello. Alternativas terapéuticas

Abstract

Patients with bulky metastases of squamous cell carcinoma of the head and neck represent a challenge for the therapeutic decision; balance between oncological control and complications should be achieved. The therapeutic sequence has no impact on survival but sequelae. We analyze the oncological results in patients with bulky metastases on the neck treated with induction chemotherapy and with up-front neck dissection. Retrospective analysis of patients undergoing treatment for cervical lymph node metastasis of squamous cell carcinoma; The therapeutic sequence was decided based on volume, resectability, site, and size of the primary and general condition of the patient. Overall survival was calculated based on human papilloma virus (HPV) status. There were 30 patients, 22 men and eight women with a mean age of 57 years, 10 N3 and 20 N2. In 13 the HPV was positive, in 5 negative and in 12 the determination was not made. Seven patients were treated with initial chemotherapy, and 23 underwent neck dissection; the 5-year survival was 25%, and the prognosis was better in the positive HPV. The treatment of cervical metastasis depends on the possibility of resection. We should favor the initial surgery. The HPV is a factor of good prognosis.