Abstract
Positron Emission Tomography/Computed Tomography in Evaluation of the Clinically N0 Neck in Head and Neck Squamous Cell Carcinoma.
Highlights
Head and neck squamous cell carcinoma (HNSCC) is characterized by a high propensity for regional lymph node metastases. 18F-labeled fluorodeoxyglucose positron emission tomography /computed tomography (PET/CT) has greatly assisted detection of occult regional and distant metastases from HNSCC as well as second primary malignancies.[1,2,3] PET/CT has an established role after definitive chemoradiation in evaluating treatment response that has led to the abandonment of planned neck dissections after definitive chemoradiation.[4]
Elective neck dissection (END) for the clinically N0 neck was advocated at the same time as definitive primary tumor excision for patients with a greater than 20% risk of occult lymph node metastases.[6]
elective neck dissection (END) is considered the standard of care for clinically N0 HNSCCs at risk for occult lymph node metastasis.[8]
Summary
Head and neck squamous cell carcinoma (HNSCC) is characterized by a high propensity for regional lymph node metastases. 18F-labeled fluorodeoxyglucose positron emission tomography /computed tomography (PET/CT) has greatly assisted detection of occult regional and distant metastases from HNSCC as well as second primary malignancies.[1,2,3] PET/CT has an established role after definitive chemoradiation in evaluating treatment response that has led to the abandonment of planned neck dissections after definitive chemoradiation.[4]. Elective neck dissection (END) for the clinically N0 neck was advocated at the same time as definitive primary tumor excision for patients with a greater than 20% risk of occult lymph node metastases.[6] This practice has recently been strengthened by level I evidence from the D’Cruz et al[7] randomized trial of END versus observation in stage I to II oral cavity squamous cell carcinoma (OCSCC).
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